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Ross Lake Resort
503 Diablo St.
Rockport WA. 98283 

Visitor's Acknowledgement of Risk

In consideration of the services of Ross Lake Resort, their officers, agents, employees, and stockholders, and all other persons or entities associated with those businesses (hereinafter collectively referred to as "Ross Lake Resort"), I agree as follows:

Although Ross Lake Resort has taken reasonable steps to provide you with appropriate equipment and skilled instruction so you can enjoy an activity for which you may not be skilled, we wish to remind you this activity is not without risk. Certain risks cannot be eliminated without destroying the unique character of this activity. The same elements that contribute to the unique character of this activity can be causes of loss or damage to your equipment, or accidental injury, illness, or in extreme cases, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for this activity, but we do think it is important for you to know in advance what to expect and to be informed of the inherent risks.

The following describes some, but not all, of those risks: Adverse weather including rough water; Floating and/or submerged obstacles such as stumps, logs, and rocks; Cold water and long distance from a major medical center.

I am aware that boating entails risks of injury or death to myself. I understand the description of these risks is not complete and that other unknown or unanticipated risks may result in injury or death. I agree to assume responsibility for the risks identified herein and those risks not specifically identified. My participation in this activity is purely voluntary, no one is forcing me to participate, and I elect to participate in spite of the risks.

I certify that I am fully capable of participating in this activity. Therefore, I assume full responsibility for myself, including my minor children, for bodily injury, death and loss of personal property and expenses thereof as a result of those inherent risks and dangers and of my negligence in participating in this activity.

I have read, understood and accepted the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon myself, my heirs, assigns, personal representative and state and for all members of my family, including any minors accompanying me. 

Today's Date: August 8, 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 Information

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
First Participant's Signature*
Second Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Third Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Fourth Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Fifth Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Sixth Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Seventh Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Eighth Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Ninth Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Tenth Participant's Name

First Name*

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

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
Parent or Guardian's Email Address

Email*

Confirm Email*
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*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Name on Equipment Reservation *
What type of equipment have you reserved? *
Motor Boat
Canoe
Kayak
Stand-up Paddle Board
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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