Loading...

Lake Cowichan Adventure Company Ltd. / Water Sports Liability Waiver Kayaking/Canoeing/Rafting/River Tubing/Swimming Release Of Liability, Waiver Of Claims, Express Assumption Of Risk And Indemnity Agreement.

Please Read and Be Certain You Understand the Implications Of Signing Express Assumption of Risk Associated with Kayaking/Canoeing/Rafting/River Tubing/Swimming and Related Activities. 

I do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with kayaking, canoeing, rafting, river tubing, swimming, transportation of equipment related to the activities, and traveling to and from activity sites of which I am about to engage in. I acknowledge that I have been supplied or upon offer, refused a personal floatation device. 

Inherent hazards and risks include but are not limited to: 

1. Risk of injury from the activity and equipment utilized in kayaking, canoeing, rafting, river tubing, swimming, and related activities is significant including the potential for broken bones; severe injuries to the head, neck, and back; or other bodily injuries that may result in permanent disability and death. 

2. Kayaking, canoeing, rafting, river tubing rollovers that may cause cuts, broken bones, and other injuries including death. 

3. Exposure to water hydraulics, hidden or obvious obstructions, and/or debris found in rivers can cause drowning or other harm. 

4. Possible equipment failure and/or malfunction of my own or others' equipment. 

5. Running into objects, persons, or animals including other boats, barely submerged logs and stumps and other hazards that are not visible. 

6. My own negligence and/or the negligence of others, including employees, agents, independent contractors or representatives of ​Lake Cowichan Adventure Company Ltd​ including but not limited to operator error and guide decision making including misjudging terrain, rapids, weather, trails, or route location. 

7. Hazards related to kayaking, canoeing, rafting, river tubing, and swimming which include but are not limited to: collision, capsizing, sinking, or other hazards that may result in wetness, injury, exposure to elements, hypothermia, impact of the body upon the water, upon rocks, injection of water into my body orifices, marine life forms, and/or drowning. 

8. Cold weather and heat related injuries and illness including but not limited to frostnip, frostbite, heat exhaustion, heat stroke, sunburn, hypothermia, and dehydration. 

9. Discharge of weapons in or near the area of activity. 

10. Dangers associated with exposure to natural elements including but not limited to avalanche, rock fall, inclement weather, rising waters, thunder and lightning, severe and/or varied wind, temperature or weather conditions. 

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

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

13. Fatigue, exhaustion, chill, and/or dizziness, which may diminish: my/our reaction time and increase the risk of accident, my sense of balance, physical coordination, and ability to follow instructions. 

14. Injury or death from encountering natural conditions, upon encountering man made conditions, encountering turbulent water, rapids, sudden narrowing of water channels, vortexes, and rapidly changing water levels. * I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death. 

15. Damage to, or loss of property placed in dry bags provided by  ​Lake Cowichan Adventure Company Ltd for the duration of Kayaking, canoeing, rafting, river tubing experience.

 

COVID-19 

16. I acknowledge the contagious nature of the Coronavirus/COVID-19 and that Island health, BC Health, and many other public health authorities still recommend practicing social distancing.

I further acknowledge that​ Lake Cowichan Adventure Company Ltd has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

I further acknowledge that ​Lake Cowichan Adventure Company Ltd can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, other customers and their families.

I, attest that:

* I am not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.

* I have not traveled internationally within the last 14 days.

* I have not traveled to a highly impacted area within the United States of America in the last 14 days.

* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.

* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.

* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

Alcohol 

17. I acknowledge the Lake Cowichan Adventure Company Ltd policy specifying that no alcohol should be consumed whilst attending or participating in Kayaking/Canoeing/Rafting/River Tubing/Swimming and Related Activities provided by Lake Cowichan Adventure Company Ltd.

I, attest that:

* I will not bring or consume alcohol on Lake Cowichan Adventure Company Ltd property including transportation shuttles.

* I will not bring or consume alcohol on the Jakes at the Lake private dock.

* I will not bring or consume alcohol for the duration of my time on the Cowichan river participating in kayaking, canoeing, rafting, river tubing, swimming, or other related activities provided by Lake Cowichan Adventure Company Ltd.

* I will not provide alcohol to anyone on the Cowichan river during my time participating in kayaking, canoeing, rafting, river tubing, swimming, or other related activities provided by Lake Cowichan Adventure Company Ltd.

Release of Liability, Waiver of Claims, and Indemnity Agreement 

In consideration for being permitted to participate in any way in kayaking, canoeing, rafting, river tubing, swimming 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 PERSON OR PROPERTY, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, THE FOLLOWING NAMED PERSONS OR ENTITIES, HEREIN REFERRED TO AS RELEASEES: ​Lake Cowichan Adventure Company Ltd. 

2. To release the releasees, their officers, directors, employees, representatives, agents, volunteers, and vessels from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releasees or otherwise. By executing this document, I agree to hold the releasees harmless and Indemnify them in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of engaging in the above activities. 

3. 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. 

Date: January 22, 2021

 

First Participant's Name

First Name*

Middle 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*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

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

Middle 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!