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Explorer Chick Adventure Co. Inc.

info@explorerchick.com
 

Explorer Chick Adventure Co, Inc.

Waiver and Release Form

THIS IS AN ENFORCEABLE AGREEMENT THAT DIRECTLY AFFECTS YOUR LEGAL RIGHTS, PLEASE READ CAREFULLY.

This agreement is between Explorer Chick Adventure Company, Inc. and Participant

Explorer Chick Adventure Company, Inc. is in the business of operating and directing “Adventure” vacation tours and excursions. All of these adventures include a variety of physical activities that will require your participation. Your reading and signing of this Waiver and Release, is to verify that you have been advised of, accept and assume all responsibility and risks for participating in these activities. Further, that you FULLY INDEMNIFY Explorer Chick and its Owner and Employees of all liabilities in this matter.

I hereby am voluntarily acknowledging the following:

My participation is completely voluntary, and I acknowledge that there are inherent risks that I am personally assuming while participating in these activities. I am freely accepting and fully assuming in every manner, risks for possible personal injury, injury to property, loss to myself or property, and possible death or serious bodily injury. I, personally and on behalf of my heirs, next of kin, executors and assigns, agree as follows:

1. To waive any and all claims known or unknown, that I may have in the future as a result of my participation in any activity sponsored by, or participated in, with Explorer Chick Adventure Co., Inc.

2. To Waive any and all claims that I may have in the future, and hold harmless all owners, directors, board members, employees, volunteers, business operators, contractors, or other participating members of, Explorer Chick Adventure Co., Inc.

3. To Waive and forever Release and Discharge Explorer Chick Adventure Co., Inc. from all liability for any personal injury, death, property damage or loss resulting from my participation in any activity due to any cause. This includes loss from negligence, failure to use reasonable care, gross negligence, or any breach of duty imposed by law, breach of contract, or mistake in error of judgment of Explorer Chick Adventure Co., Inc. and its associates.

4. To be personally liable, holding harmless and indemnifying Explorer Chick Adventure Co., Inc., from all actions, proceedings, claims, damages, and costs demands, including but not limited to court costs, medical costs, or liabilities what-so-ever of any nature arising out of, or connected in anyway with my participation in the activities or trips organized by, or promoted by, Explorer Chick Adventure Co., Inc.

Full Disclosure of Health and Physical Condition

I, the undersigned, being aware of my own health and physical condition, do hereby swear that I have no existing condition that would limit my participation in any activity that requires physical assertion on my behalf.

Having complete knowledge of my own health and physical condition, and fully being made aware that the activities that I will be participating in requires physical assertion, and includes intense physical activities, do hereby waive and release Explorer Chick Adventure Co, Inc., and all of its affiliates, from all liability as a result of my participation in these activities.

Participation Agreement

Recognizing there are inherent risks that I am assuming by my participation in this organized trip, I also agree to abide by all rules, posted warnings, instructions, and or directions given by Explorer Chick Adventure Co., Inc., or any agents thereof.

Explorer Chick may contract with independent contractors to provide transportation, guide services, excursions and/or all other related travel services. Explorer Chick assumes no responsibility, however caused, for injury, loss or damage to person or property in connection with any service provided by an independent contractor or resulting directly from the following: - acts of God - detention - annoyance - terrorism - thefts - pilferage - force majeure - civil disturbances - government restrictions or regulations - strikes - delays and expenses arising from quarantine - failure of any means of conveyance to arrive or depart as scheduled - discrepancies or change in transit or hotel services over which Explorer Chick has no control. I agree to sign all releases required by any participating organization and to follow their rules completely.

Explorer Chick reserves the right to decline to accept or retain any person as a tour participant should such person's behavior, health or mental condition impede the operation of the trip.

Explorer Chick reserves the option to modify trip itineraries at the discretion of your tour director as necessary due to weather, conditions, illness, injury, group dynamics, safety, or other unforeseen incidents.

In addition to the above, I understand I can obtain personal medical coverage, or additional insurance, that would cover injuries received on this trip and/or excursion. Furthermore, I agree to use my personal medical insurance for any medical coverage or medical payment for injury incurred by me while on this trip and/or excursion.

I understand that I may purchase travel insurance to cover certain risks inherent in travel such as supplier bankruptcy and the inability to travel due to a medical or personal emergency.

Dispute Resolution

This Agreement is to be governed by and construed in accordance with the laws of the STATE OF OHIO without reference to any principles of conflicts of laws, which might cause the application of the laws of another state. 

Pre-Arbitration Procedures.  In the event of any dispute or controversy arising out of or relating to this Agreement, including its validity, enforceability, performance or breach, the Party alleging a dispute will notify the other party of the existence of the dispute, and provide reasonable detail about the dispute.  Officials representing both parties will meet and attempt to resolve the dispute within FIFTEEN (15) DAYS of the notice.

Arbitration.  In the event party officials do not meet or are unable to resolve a dispute within the above period, the dispute shall be resolved exclusively by final binding arbitration in accordance with current Commercial Arbitration Rules of the American Arbitration Association (AAA).  The parties shall endeavor to select a mutually acceptable arbitrator within FIFTEEN (15) DAYS of the notice of a demand of arbitration.  In the event the parties are unable to agree to such a selection, AAA procedures shall be used to select a single arbitrator.

The costs for the arbitration and the fees of the arbitrator shall be shared equally by the parties.  All parties agree that arbitration shall take place within the COUNTY OF HAMILTON, OHIO.  The arbitrator shall not have the authority, power or right to award punitive damages.  The arbitrator shall have the power to issue mandatory orders and restraining orders in connection with the arbitration.  The arbitrator shall endeavor to commence the arbitration within SIXTY (60) DAYS of the arbitration notice.  A written award shall be rendered by the arbitrator within THIRTY (30) DAYS of the end of the arbitration hearing(s), and shall be final and binding on the parties.  Judgment may be entered thereon in any court having jurisdiction.

Continued Performance Pending Dispute Resolution.  Pending the resolution of the dispute, the parties shall, without delay, continue to perform their respective obligations under this Agreement.

Acknowledgement of Physical Demands

Explorer Chick states the physical demands for each multi-day trip on the trip’s individual web page. You are responsible for reading the physical demands and ultimately deciding if you are physically capable of participating in your selected trip.

By authorizing this form:

You acknowledge that you are aware of the physical demands of your trip and are fully able to meet the minimum requirements as stated on the trip’s web page.

You confirm that you have the physical functionality, motor skills, strength, and physical attributes to perform these physical activities.

Social Media, Website, Publicity and Image Waiver and Release

Explorer Chick Adventure Company, Inc. reserves the rights to use any and all images taken of all persons during participation in any event sponsored, co-sponsored or related to the business of Explorer Chick Adventure Co, Inc. This Media Waiver is releasing any and all liability of Explorer Chick Adventure Company, Inc., and allowing the use of all forms of Image duplication for use in marketing, social media, print, the website or any other legal duplication of said images, without compensation.

I have completely read, and fully understand this waiver and release, and comprehend with complete understanding the legal terms, and ramifications of these terms, used herein. This waiver and release is freely and voluntarily given, and understand that I am waiving any and all legal recourse, now and forever, that I may have against Explorer Chick Adventure Co., Inc.

THIS IS A LEGALLY BINDING AGREEMENT; MAKE SURE YOU UNDERSTAND ALL OF ITS PROVISIONS BEFORE SIGNING.

My signature below is intended to, and does bind myself, my heirs, successors, representatives, administrators, and assigns. I have received this waiver in plenty time to have it reviewed by an attorney, and am waiving that right.

Date: August 16, 2018

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*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
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.


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