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This waiver covers all the information you need to know about participating in one of our activity sessions. 

RECREATIONAL ACTIVITY RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK, INDEMNITY

AGREEMENT, AND PHOTO RELEASE

 

Please read and be certain you understand the implications of signing.

 

Express Assumption of Risk Associated with Recreational Activities.

I hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with the recreational activity

generally described as but not limited to kayaking, coasteering, surfing, rock climbing and other outdoor activities,

including the rental of equipment and transportation associated therewith in which I am about to engage. Inherent hazards and risks include but

are not limited to:

1. Risk of injury from the activity and equipment utilized is significant including the potential for permanent disability and

death.

2. Possible equipment failure and/or malfunction of my own or others’ equipment.

3. This activity or portions of it takes place outdoors and therefore includes risks associated with exposure to elements,

excessive heat, hypothermia, impact of the body upon the snow, encountering objects either natural or man-made,

exposure to animals with the attendant risk of kicking, biting, shying away, running off or otherwise moving in an

unanticipated manner causing injury and/or death.

4. My own negligence and/or the negligence of others, including but not limited to operator error and guide decision

making including misjudging terrain, rapids, weather, trails, or route location.

5. Attack by or encounter with insects, reptiles, and/or animals.

6. Accidents or illness occurring in remote places where there are no immediately available medical facilities.

7. Fatigue, chill, and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.

 

*I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury,

illness, or death.

 

Release of Liability, Waiver of Claims , Indemnity Agreement, and Photo Release

In consideration for being permitted to participate in the activity (ies) described above and related activities, I hereby agree,

acknowledge and appreciate that:

1. I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or

damage to personal property. Accidents can happen without any contributory negligence from the company or its staff. The company

can accept no responsibility for loss or damage to personal property or for personal injury not arising as a result of its own act or default.

activities.

3. I hereby give Active Avdentures NI, its officers, directors, employees, contractors, vendors, affiliates, and agents, and its assigns, licensees, successors

in interest, legal representatives, and heirs the irrevocable right to use and make photographs (still, film, tape or

otherwise), to use and record with a video or audio recording device, my name (or any fictional name), picture, portrait, photograph, and/or

likeness in all forms and in all media and in all manners (“Likeness”), without any restriction as to changes or alterations (including but not

limited to blurring, distortion, alteration, optical illusion or use in composite form, or derivative works of my Likeness made in any medium,

whether intentional or otherwise) in connection with the activity (ies) through the Company’s business, products and/or services, including but

not limited to for advertising, for publication or any other lawful purposes. I waive any right to inspect, modify, or approve any intermediary

version(s) or finished version(s) of the results of the use of my likeness (“Results”). I waive any right to further compensation.

4. By entering into this Agreement, I am not relying on any oral or written representation or statements made by the releasees, other than what

is set forth in this Agreement. This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be

unenforceable, the remaining terms shall be enforceable.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND I FULLY UNDERSTAND ITS

TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND

VOLUNTARILY WITHOUT ANY INDUCEMENT. I REPRESENT THAT I AM OVER 18 AND LEGALLY COMPETENT TO EXECUTETHIS AGREEMENT, WHICH SHALL BE A BINDING COMMITMENT.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Third Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Fourth Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Fifth Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Sixth Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Seventh Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Eighth Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Ninth Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Tenth Participant's Name

First Name*

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

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
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*
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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Height *

Waist size

Date of session *
Which activity?*
Coasteering
Kayaking
Both
Paddleboarding
Beginner's Course
AM, PM or late afternoon session?*
AM
PM
Both
I declare that I do not have any medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)*
No
Yes
I agree not to drink alcohol or take prohibited drugs before or during activities.*
No
Yes
I declare I do not have any COVID19 or flu symptoms and agree to abide by social distancing at all times.*
No
Yes
Can you swim 50 metres (150 feet)?*
No
Yes
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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