Loading...

Declaration Form Uteguiden AS
 

GUIDED TRIPS & COURSES

I am aware that the activity I am about to take part in has certain risks. Before I participate, 

By signing this form, I stat that I have read Uteguiden AS saftey rules which is found here: https://uteguiden.com/en/safety/ and I am stating that Uteguiden and their instructors/guides have informed me about these risks and I will follow any instructions given and avoid these risks.

I agree that Uteguiden or its guides can´t be held responsible for personal injury, equipment loss or damage when this is caused as a consequence of not following instructions given.

I agree that any lawsuits brought towards Uteguiden or the company´s guides must be brought in front of a Norwegian court following the laws of Norway.

I have informed the instructor/guide of any medical information that may be of importance to my performance during this activity.

I am aware that the guide may be taking photos during the trip and agree to these being used by Uteguiden for marketing purpose only.

I take full responsibility for the equipment rented or borrowed from Uteguiden AS or their partners.

Today's Date: October 24, 2021

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
GUIDED TRIPS & COURSES

Date

Time

Ship / Trip
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*
Parent or Guardian's Information

Do you have any illness (Diabetes, allergies, epilepsy etc.) or injuries (back, knee, shoulder, head etc.) we should now about? Do you use any medicine?
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 - TRY IT FREE!