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CLAY GULLY OUTFITTERS, SIELER HOLDINGS, LLC
Assumption and Acknowledgment of Risks and Release of Liability Agreement
Airboat Waiver

 

I, as the name listed below, in consideration of being allowed to participate as a passenger aboard an airboat watercraft in watersport events and activities, for myself and any minor children for whom I am parent, legal guardian or otherwise responsible, and for my/our heirs,  personal representatives or assigns, I hereby:

A. ACKNOWLEDGEMENT OF RISKS. Acknowledge that some, but not all, of the risks of participating in airboat watersport activities include:
1. Changing water flow, tides, currents, wave action and ships’ wakes,
2. Collisions with any of the following: other participants, the watercraft, other watercrafts, and manmade or natural objects,
3. Wind, inclement weather, lightning, variances and extremes of wind, weather, and temperature,
4. Either temporary or permanent changes in my sense of hearing,
5. My sense of balance, physical coordination, ability to operate equipment, swim and/or follow directions,
6. Collision, capsizing, sinking or other hazard which results in wetness, injury, exposure to the elements, hypothermia, and/or drowning,
7. The presence of insects and marine life forms,
8. Equipment failure or operator error,
9. Heat or sun related injuries or illnesses, including sunburn, sunstroke or dehydration,
10. Fatigue, chill and/or dizziness, which may diminish my/our reaction time and increase the risk of an accident.

B. EXPRESS ASSUMPTIONS OF RISK AND RESPONSIBILITY. Agree to assume responsibility for all the risk of the activity, whether identified above or not. My/our participation in the activity is purely voluntary. I assume full responsibility for myself and my minor children for whom I am responsible, for any bodily injury, accident, illness, paralysis, death, loss of personal property and expenses thereof as a result of any accident, whether resulting from negligence or otherwise, that may occur while I/we participate in the activity.

C. RELEASE: Release CLAY GULLY OUTFITTERS, SIELER HOLDINGS LLC, its principals, directors, officers, agents, employees and volunteers, their insurers and each and every land owner, municipal and/or governmental agency upon whose property an activity is conductedand their insurers, from any and all liability of any nature for any and all injury or damage (including death) to me or my minor children and other persons, whether due to their negligence, in whole or in part, or otherwise, regardless of the cause.

D. INDEMNITY & HOLD HARMLESS. Will indemnify and hold harmless CLAY GULLY OUTFITTERS, SIELER HOLDINGS, LLC its principals, directors, officers, agents, employees and volunteers, their insurers and each and every land owner, municipal and/or governmental agency upon whose property an activity is conducted and their insurers, for any and all liability of any nature for any and all injury or damage (including death) to me or my minor children and other persons, whether due to their negligence in whole or in part, or otherwise, regardless of the cause.

 

By signing this waiver, I acknowledge that I am giving up certain legal rights and that I have read, understood, and accepted this Assumption and Acknowledgment of Risks and Release of Liability Agreement.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
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
A signed copy of this waiver will be sent to the email address you provide.
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*

Phone*
Parent or Guardian's Date of Birth*
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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