Loading...

Virginia Fishing Adventures/ Virginia Outside LLC.

Risk Acknowledgement

Please Read Carefully Before Signing

SECTION 1

In consideration for my being permitted to participate in the activities of VIRGINIA FISHING ADVENTURES LLC, NC OUTSIDE, VIRGINIA OUTSIDE, and ROANOKE OUTDOORS LLC I acknowledge the following       

  I acknowledge that fishing, boating, hiking and mountain biking have inherent risks, hazards, and dangers for anyone, that cannot be eliminated, particularly in a wilderness environment. I UNDERSTAND THAT THESE RISKS, HAZARDS, AND DANGERS INCLUDE WITHOUT LIMITATION:

                 1. Water hazards in boating and wading in rivers and ponds including drowning and exposure to water born illness

                 2. Hiking in rugged country

                 3. Injuries from fishing equipment and other participants

                 4. Encounters with wildlife, animals, and insects

                 5. Temperature extremes

                 6. Inclement weather conditions and unavailability of immediate medical attention in the wilderness in case of injury.

                 7.Falling from a mountain bike

         

I understand the risks, hazards, and dangers of fishing, and other outdoor activities and have had the opportunity to discuss them with ONE OR MORE COMPANIES LISTED IN SECTION 1. I understand these activities may require good physical conditioning and a degree of skill and knowledge. I believe I have that good physical conditioning and the degree of skill and knowledge necessary for me to engage in these activities safely. I understand that I have responsibilities. My participation in this activity is purely voluntary. No one is forcing me to participate and I elect to participate in spite of the risks. I AM VOLUNTARILY USING THE SERVICES OF ONE OR MORE COMPANIES LISTED IN SECTION 1 WITH FULL KNOWLEDGE OF THE INHERENT RISKS OF INJURY, PARALYSIS, OR DEATH.

Lastly, I, for myself, my heirs, successors, executors, and subrogees, hereby KNOWINGLY AND INTENTIONALLY WAIVE AND RELEASE INDEMNIFY AND HOLD HARMLESS ONE OR MORE COMPANIES LISTED IN SECTION 1 and all landowners on whose property they operate, their directors, officers, agents, employees, and volunteers from and against any and all claims, actions, causes of action, liabilities, suits, expenses (including reasonable attorneys’ fees) which are related to, arise out of, or are in any way connected with my participation in this activity including, but not limited to, NEGLIGENCE of any kind or nature, whether foreseen or unforeseen, arising directly or indirectly out of any damage, loss, injury, paralysis, or death to me or my property as a result of my engaging in these activities or the use of these services, animals or equipment, whether such damage, loss, injury, paralysis, or death results from negligence of ONE OR MORE COMPANIES LISTED IN SECTION 1. Or from some other cause. I, for myself, my heirs, my successors, executors, and subrogees, further agree not to sue ONE OR MORE COMPANIES LISTED IN SECTION 1 OR any landowner on whose property they operate. As a result of any injury, paralysis, or death suffered in connection with my use and participation in the activities of ONE OR MORE COMPANIES LISTED IN SECTION 1.

Additionally, I acknowledge and approve that photos/video may be taken of participants during programs and used for advertising purposes in print, on social media, and on the company’s website or other websites aimed at promoting the company’s activities.

I HAVE CAREFULLY READ, CLEARLY UNDERSTAND, AND VOLUNTARILY SIGN THIS WAIVER AND RELEASE AGREEMENT.

Dated: December 21, 2024


First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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, Guardian or Custodian Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last 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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent, Guardian or Custodian Name

First Name*

Last Name*

Phone*
Parent, Guardian or Custodian Age Acknowledgment*
Parent, Guardian or Custodian Date of Birth*
I certify that I am 18 years of age or older
Parent, Guardian or Custodian 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 - TRY IT FREE!