Loading...

Kayak New Mexico, Inc.
RELEASE OF LIABILITY - READ BEFORE SIGNING

In consideration of being allowed to rent equipment or participate in any way in the Kayak New Mexico, Inc. ("KNM") program, its related events and activities, I, the undersigned, acknowledge, understand, appreciate, and agree that:

  1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist.
  2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, including any other property damage or loss, EVEN IF ARISING FROM THE NEGLIGENCE OF KNM or others, and I assume full responsibility for my participation.
  3. To the extent permitted by law, I WAIVE any claim that I may have against KNM, its directors, officers, employees, agents and independent contractors, for any injury or loss that I suffer as a result of my rental of equipment from KNM or my participation in any KNM activity, whether the injury or loss is due to the negligence of KNM or the conduct of third parties. This means that I am giving up my right to sue KNM for any such injury or loss.
  4. I agree to INDEMNIFY AND HOLD HARMLESS KNM, its directors, officers, employees, agents and independent contractors from all claims, demands, losses and liability (including attorney's fees) that arise from or relate to my rental of equipment from KNM or my participation in any KNM activity. This means I will pay KNM for any loss by KNM connected to my rental of equipment from KNM or my participation in any KNM activity.
  5. I acknowledge that KNM and, if applicable, the owners and lessors of premises used to conduct any KNM activity are not responsible for any possessions or valuables that I may choose to bring with me, and I take full responsibility for any such items that I choose to bring with me to a KNM activity. I agree not to seek compensation of any sort from KNM for any loss or damage to any personal items.
  6. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of KNM immediately.
  7. I will notify KNM of any medical or health condition that may cause injury to myself or others, or may require emergency care during my participation in any KNM activity.
  8. I agree to allow KNM to use photographs and video of me and the event to be used in any promotional material.
  9. I agree to pay all costs, including attorney's fees, incurred by KNM in enforcing or defending any rights under this Agreement. I agree that this Agreement shall be governed by the laws of the State of New Mexico and that any disputes relating to this Agreement shall be brought in Sandoval County, New Mexico.
  10. This Agreement shall be binding upon my heirs, administrators, personal representatives and assigns in the event of my death.
  11. If any portion of this Agreement is deemed unenforceable, the remaining portions and provisions shall remain in full force and effect.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Date Signed: September 22, 2019

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Would you like to know about future Adaptive Kayaking events, scholarships, camps, and outings?

Please provide your email address here:
Areas of Interest:
ADD / ADHD
Autism / ASD
Cancer / Survivor
Cerebral Palsy
Down Syndrome
Epilepsy
Learning Disability
Intellectual Disability
Multiple Sclerosis
Muscular Dystrophy
Traumatic Brain Injury
Other

If Other, please list:
Other areas of interest:
Regular Classes
Recreational
Whitewater
Touring
SUP
Families & Kids
Professional (therapist, social worker, school teacher, day-habilitation, etc.)
Volunteer
Peer

How did you find out about us?

Comments:
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of KNM, its directors, officers, employees, agents, and independent contractors, and, for myself, my child, and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless KNM, its directors, officers, employees, agents, and independent contractors from any and all liabilities associated with my minor child's involvement with the rental of equipment from KNM or participation in any KNM activity as provided above, to the fullest extent permitted by law.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver