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Campbellford Paddle

SUP Lesson or Rental, Kayak or CanoeRental

WAIVER, RELEASE AND AGREEMENT

(Please read completely before signing and ask questions if there is anything you do not understand.)

In consideration of being allowed to participate in any way in Campbellford Paddle lessons, rentals, related events and activities, the undersigned acknowledges, appreciates and agrees 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 rules, equipment and personal discipline may reduce this risk, the risk of serious injury does exist; and

2. Stand up paddleboards, kayaks, canoes, pedalboats, leashes, paddles, all equipment used in watersports and the natural surroundings, including water, docks, rocks, and shoreline areas are potentially hazardous objects; and lake and river conditions can change quickly, the water may decrease in temperature rapidly, wave height may increase or decrease, visibility in the water may fluctuate, current may be strong, or depth of water will change, under, above and floating water obstacles such as rocks or debris may be present and I respect the lake and river’s power; and

3. An SAE approved Personal Floatation Device, whistle, SUP leash, or other legally required safety gear, were provided and I acknowledge that Campbellford Paddle has encouraged me to use them appropriately at all times while on the water; and I will not approach any obstacle or object, including but not limited to boat wakes, shorelines, shallow water, rocks, or docks, in an unsafe manor such as remaining in a standing position on a SUP; and

4. Stand up paddling, kayaking, canoeing, pedalboating, and swimming can be strenuous physical activities involving varying depths of water; and I am in average to above average physical condition; and my swimming ability is adequate to engage safely in watersports; and

5. I have no preexisting medical or other condition that would affect the safe participation in these activities; or I have consulted my physician as to the advisability of participating in these activities; and I will inform Campbellford Paddle of any changes in my health or physical condition prior to any lesson or rental; and

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 the nearest Campbellford Paddle staff immediately; and

7. I understand that I will be held financially accountable for any damage to items rented that may occur while I or my child/ward is using them.  Further, I understand that should it become necessary to provide rescue of me or my child/ward, while using a rented item, a charge will apply based on time required and any cost incurred by Campbellford Paddle.

8. I hereby give Campbellford Paddle, its assigns, licensees and legal representatives the irrevocable right to use the name/image of the child named above in its public relations and communication materials created. I realize that I may withdraw my consent in writing at any time by contacting Campbellford Paddle. I understand that the photograph(s) may be used in a publication, print advertisement, electronic media (e.g., video, CD-ROM, internet, World Wide Web, Social Media, etc.) or other form of communication. In giving my consent, I hereby release and hold harmless Campbellford Paddle and their agents, employees, officials, representatives and contractors from any and all responsibility or liability for damage of any kind suffered in any manner whatsoever. I hereby relinquish any and all personal or proprietary rights I may have in connection with such use. I understand that I will receive no compensation should any photograph of me be used.

9. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, knowingly and freely assume all risks, both known and unknown, and hereby release and hold harmless Heather Zak, Mark Malcolm, and Campbellford Paddle, their officers, officials, volunteers, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the activities (“Releases”), with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by the negligence of the releasees or otherwise.

9. This Agreement shall remain in effect for all future lessons, clinics, or rentals from Campbellford Paddle.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK 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: July 23, 2018

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

My city/country of residence is...
First Participant's Signature*
Second Participant's Name

First Name*

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

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Third Participant's Name

First Name*

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

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Fourth Participant's Name

First Name*

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

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Fifth Participant's Name

First Name*

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

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Sixth Participant's Name

First Name*

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

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Seventh Participant's Name

First Name*

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

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Eighth Participant's Name

First Name*

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

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Ninth Participant's Name

First Name*

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

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Tenth Participant's Name

First Name*

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

My city/country of residence is...
Parent or Guardian's Email Address

Email*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
This is to certify that I, as parent/guardian with legal responsibility for this /these participant/s, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child/s' involvement or participation in these programs as provided above. Further, I hereby authorize Campbellford Paddle to use the name/image of the child named above in its public relations and communication materials created. I realize that I may withdraw my consent in writing at any time by contacting Campbellford Paddle. I understand that the photograph(s) may be used in a publication, print advertisement, electronic media (e.g., video, CD-ROM, internet, World Wide Web, Social Media, etc.) or other form of communication. In giving my consent, I hereby release and hold harmless Campbellford Paddle and their agents, employees, officials, representatives and contractors from any and all responsibility or liability for damage of any kind suffered in any manner whatsoever. I hereby relinquish any and all personal or proprietary rights I may have in connection with such use. I understand that I will receive no compensation should any photograph be used.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

My city/country of residence is...
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.


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