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Canoe & Kayak
626 NW Arizona Ave. Suite 7
Bend, OR 97703

Release of Liability

Release. The undersigned (Releasor) acknowledges that on this date May 1, 2025 his/her child's attendance at or use of Canoe & Kayak including without limitation participation in any program or activity and use of the equipment and facilities, could cause injury, which may result from or arise out of attendance at or use of Canoe & Kayak or activities. Releasor agrees on behalf of himself/herself and on behalf of his or her child or children, and his/hers heirs, executors, administrators, and assigns, to fully and forever waive, indemnify and hold harmless, release and discharge Canoe & Kayak, its affiliates and all of its respective officers, trustees, employees, agents, successors and assigns (collectively Releasees), from any and all claims, damages, demands, rights of action or causes of action, present or future, known or unknown, anticipated or unanticipated, resulting from or arising out of attendance at or use of the Canoe & Kayak or activities, whether related to exercise or not. Releasor acknowledges that he/she has carefully read this Waiver and Release and fully understands that it is a waiver and release of any and all liability.

 

** This waiver is used for testing WCAG 2.1 Compliance and accessibility guidelines ***

First Student's Name

First Name*

Middle Name

Last Name*
First Student's Age Acknowledgment*
First Student's Date of Birth*
I certify that I am 18 years of age or older
First Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

First Student's Signature*
Second Student's Name

First Name*

Middle Name

Last Name*
Second Student's Date of Birth*
Second Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Third Student's Name

First Name*

Middle Name

Last Name*
Third Student's Date of Birth*
Third Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Fourth Student's Name

First Name*

Middle Name

Last Name*
Fourth Student's Date of Birth*
Fourth Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Fifth Student's Name

First Name*

Middle Name

Last Name*
Fifth Student's Date of Birth*
Fifth Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Sixth Student's Name

First Name*

Middle Name

Last Name*
Sixth Student's Date of Birth*
Sixth Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Seventh Student's Name

First Name*

Middle Name

Last Name*
Seventh Student's Date of Birth*
Seventh Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Eighth Student's Name

First Name*

Middle Name

Last Name*
Eighth Student's Date of Birth*
Eighth Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Ninth Student's Name

First Name*

Middle Name

Last Name*
Ninth Student's Date of Birth*
Ninth Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Tenth Student's Name

First Name*

Middle Name

Last Name*
Tenth Student's Date of Birth*
Tenth Student's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

Parent or Guardian's Email Address

Email*
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Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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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 or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Skill level:*

List any injuries
What will you be renting?*
Canoe
Kayak
Other

IMPORTANT INFORMATION

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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