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KODIAK LODGE AT LARSEN BAY RELEASE, WAIVER, AND INDEMNITY AGREEMENT

I, releasor, understand that Kodiak Lodge of Larsen Bay, Ltd. (“Kodiak Lodge”) provides a service to me, by permitting me to participate in fishing, boating, and hunting activities in a remote location in Alaska. These activities, by their nature, are inherently dangerous.

In consideration of my participation in such activities, I, on behalf of myself and my legal representatives, heirs and assigns, release, waive, promise not to sue, and agree to indemnify and hold harmless Kodiak Lodge and its officers, directors, employees, agents, independent contractors, promoters, and assigns (the “Releasees”) for and from all liability for every claim and right of action of every kind, arising from or by reason of any injury to me (including any injury causing death) or damage to my property occurring during my stay at Kodiak Lodge or any fishing, boating, hunting, or related activities conducted by or at Kodiak Lodge, including travel to and from such activities. I assume full responsibility for the risk of any such injury or property damage.

I acknowledge that the remote and dangerous nature of activities conducted during my stay at Kodiak Lodge will make rescue and assistance in the event of emergency difficult. The above- described release and agreement to indemnify and hold harmless shall apply to all claims and rights of action on account of first aid, treatment, rescue, or assistance rendered (or not rendered) to me during my stay at Kodiak Lodge or while I am participating in fishing, boating, hunting, or related activities conducted by or at Kodiak Lodge (including travel to and from such activities).

I expressly agree that this release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the laws in the State of Alaska, and that if any portion thereof is held invalid, it is agreed that the balance shall continue in full legal force and effect.

I acknowledge that before signing the foregoing release, waiver and indemnity agreement, I have carefully read and fully understood its terms, including the assumption of risk and waiver of liability, and sign this release as my own free act.

KODIAK LODGE RESERVES THE RIGHT TO REFUSE SERVICES TO GUESTS WHO DO NOT SIGN THIS AGREEMENT.

Today's Date: October 31, 2020

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*
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I am the parent / guardian / or other representative capacity of the above-named minor child. I have read and fully understood the terms of this release, waiver and indemnity agreement, including the assumption of risk and waiver of liability. I agree, on behalf of said child, to comply with and bound by, and cause said child to comply with and be bound by this release, waiver and indemnity agreement.
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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