Loading...

Trip & Course & Workshop

Participation Release of Liability & Assumption of Risk

Please read the following Participation Release and Assumption of Risk carefully as your acknowledgement and voluntary acceptance is a pre-condition of trip/program participation.

In consideration of being allowed to participate in any way in a Naturally Superior Adventures/Rock Island Lodge (releasees) program, related events and activities, I, the undersigned acknowledges, appreciates and agrees that;

  1. The risk of injury from the activities involved in adventure travel including this program is significant, including potential for permanent disability and death, and while particular guidelines, equipment and personal discipline may reduce this risk, the risk of serious injury does exist; from factors including, but not limited to terrain, isolation, animals and weather; and,
     
  2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees, or others, and assume full responsibility for my participation; and,
     
  3. 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 or if I am uncomfortable with participating in an program/activity, I will remove myself from participation and bring such to the attention of the nearest staff/guide immediately; and,
     
  4. I for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless Naturally Superior Adventures/Rock Island Lodge, its officers, officials, agents and or employees, other participants, sponsoring agencies, sponsors, advertisers and, if applicable, owners and lessors of premises used to conduct the event (“Releasees”), with respect to any and all injury, disability, death, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by the law.
     
  5. I agree I will be fully and financially responsible for my own physical condition and well being during the program. I am medically, physically and in all respects fit and able to participate in adventure travel. I have no medical requirement or condition except what is outlined in the Registration/Medical form. I will inform Naturally Superior Adventures/Rock Island Lodge of any significant changes to my physical or medical condition prior to my trip.
     
  6. Any disputes or claims arising out the relationship between myself, and on behalf of my heirs, assigns, personal representatives and next of kin and the releasees, shall be determined according to the laws of the province of Ontario and shall be adjudicated upon within Ontario.

I acknowledge that I have read and fully understand this release of liability and assumption of risk agreement and its terms and understand that I will be giving up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

I Agree
 Dated: April 26, 2019

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 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*
Parent or Guardian's Email Address

Email*

Confirm Email*
What trip, course or workshop are you doing?

A brief descriptor of your scheduled trip/program name or custom trip leader please. *
This is to certify that I, as parent/guardian with legal responsibility for the participant, do consent and agree to his/her release as provided above of all Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law.
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 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