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Toledo Community Boathouse
P.O. Box 428
Toledo, OR 97391
541-336-5207

Release and Waiver of Liability and Indemnity Agreement:

The participant, or parent or guardian of any participant under the age of 18, participating in any Port of Toledo (POT) and/or Oregon Boating Foundation (OBF) activities must read, understand, and sign this for prior to participation in POT and/or OBF programs.

There are risks and dangers (foreseeable and unforeseeable) associated with participation in boating activities which could result in bodily injury, partial or total disability, paralysis or death. The social and economic losses and/or damages which could result from those risks and dangers described above could be severe. These risks and dangers may be caused by the action or inaction of individuals as participant or by the action, inaction or negligence of others, including but not limited to the POT and/or OBF or any of its members, directors, officers, agents, instructors or employees.

I accept and assume such risks and responsibilities for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of POT, OBF or any of its members, directors, officers, agents, instructors or employees.

I hereby release, waive, discharge and covenant not to sue POT, OBF or any of its members, directors, officers, agents, instructors or employees from all liability to individual/parent/guardian, personal representatives, assigns, executors, heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including but not limited to participant's death or the damage to property, caused or alleged to be caused in whole or in part by the negligence of POT, OBF or any of its members, directors, officeers, agents, instructors or employees.

I execute this waiver and release on my own behalf freely and voluntarily. If, despite this release, I or any of my representatives make a claim against any of the persons or entities intended to be released, I agree to reimburse those persons to be released and their insuring company, if any, for any money which they have paid to defend a claim or by way of damages which may be awarded to participant/parent/guardian or their representative. I hold the POT, OBF or any of its members, directors, officers, agents, instructors or employees harmless from any claim or cost.

I have read the above waiver and release, understand that I give up substantial rights by signing it, and sign it voluntarily with full understanding of the above terms.

POT and OBF reserve the right to photograph program participants for publicity purposes. POT and/or OBF agrees to provide a photo of a participant to the participant upon request.

BY SIGNING THIS AGREEMENT, THE PARTICIPANT OR PARENT/GUARDIAN AFFIRMS HAVING READ AND UNDERSTOOD IT and agrees to follow the conditions listed above.

First Participant's Name

First Name*

Last Name*
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*
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*
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.


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