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FLYWAY

Zipline at BPD

4301 Lawndale Dr.

Greensboro, NC 27455

(336) 288-3769 (ext 1399)


RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK AND INDEMNIFICATION AGREEMENT

WHEREAS the GREENSBORO SCIENCE CENTER and THE CITY OF GREENSBORO (hereinafter "GSC") has available the FLYWAY ZIPLINE; and the GSC agrees to allow me to participate in the FLYWAY ZIPLINE in consideration of both my payment of the fees for the same and my execution of this Release and agreeing to be bound by its terms.

NOW, THEREFORE, IN CONSIDERATION of the foregoing and agreeing to be bound by the terms hereof, I hereby agree as follows:

(1) I am aware of and fully understand the inherent dangers involved in participating in the FLYWAY ZIPLINE provided by the GSC, including the risk of death and/or personal injury or damage to myself, other persons and/or my property or the property of others while participating in such activities or having my property at the site of such activities. I may not be covered under insurance of the GSC. I freely and voluntarily execute this Release with such knowledge, and assume full and sole responsibility for the risk of death, personal injury and/or property loss arising from or in any way connected with my participation in the FLYWAY ZIPLINE provided by the GSC.

(2) I agree to abide by all regulations that the GSC may impose regarding the operation and utilization of the FLYWAY ZIPLINE. I specifically acknowledge that I will be required to listen carefully during the mandatory briefing session presented by the GSC, to follow all safety rules and to undertake all activities in a responsible manner. IF I AM UNWILLING OR UNABLE TO FOLLOW ANY SAFETY RULES ASSOCIATED WITH THE FLYWAY ZIPLINE, GSC STAFF WILL TERMINATE MY CONTINUATION OF SUCH ACTIVITIES, AND I WILL NOT BE ENTITLED TO ANY REFUND OF MY ADMISSION FEE.

(3) Participants acknowledge that they may not be supervised or observed by staff at all times during their participation in any FLYWAY ZIPLINE activity.

(4) I have no pre-existing physical or emotional issue(s) which would adversely affect my ability to participate in any FLYWAY ZIPLINE activity that I or the group I am with may perform. Medical conditions that would adversely affect my participation are but are not limited to: pregnancy, high-blood pressure, heart condition, spinal injury and weak spine. I am not under the influence of any drug, including alcohol, which would adversely affect my ability to participate in any FLYWAY ZIPLINE activity.

(5) I hereby release and forever discharge the GSC, its agents, directors, employees, volunteers, and independent contractors and their respective sureties, insurers, successors, assigns and legal representatives, from any liability, claim, cause of action, demand and damages for injury, death or damages of any kind or nature whatsoever to me or my property as a result of my participation in the FLYWAY ZIPLINE, whether such injury, death or property damage is caused by the intentional or negligent act or omission on the part of (i) any other participant in the FLYWAY ZIPLINE provided by the GSC, (ii) any employee, agent, volunteer or independent contractor of the GSC, or (iii) any other person at the GSC. Furthermore, I agree to pay any and all attorney’s fees and costs of the GSC, and any of its agents, directors, employees, volunteers and independent contractors if I bring any action, claim or demand against the GSC or any of its agents, directors, employees, volunteers, or independent contractors for any reason for which this Release applies.

(6) I agree to indemnify and hold the GSC, its agents, directors, employees, volunteers, and independent contractors, their sureties, insurers, successors, assigns and legal representatives harmless from any liability, claim, cause of action, demand or damages for injury, death or damages of any kind or nature whatsoever to any person or their property as a result of my participation in the FLYWAY ZIPLINE as a result of any actual or claimed intentional or wrongful act or omission by me arising from or as a result of my participation in the FLYWAY ZIPLINE. Furthermore, I agree to pay attorney's fees and costs for any persons covered herein for any action arising under this Paragraph, whether or not such action is well-founded.

(7) I agree to and hereby bind my heirs, executors, assigns and all other legal representatives by executing this Release.

(8) I hereby acknowledge and agree that this agreement is intended to be construed and interpreted as broadly and inclusively as permitted by the laws of North Carolina. In the event of a dispute between the GSC and me, I understand and agree that any mediation or suit will be filed and maintained exclusively in Guilford County. If any portion of this Release is found or declared to be invalid or unenforceable, such invalidity shall not affect the remainder of this Release not found to be invalid, and the remainder of this Release shall remain in full force and effect.

(9) I authorize the GSC to administer all first aid measures I may need, including the decision to have me transported to a hospital, all of which will be done at my expense.

(10) I understand that I may be photographed or videotaped while participating in the FLYWAY ZIPLINE activities, and I consent to the use of such images for informational and publicity purposes on the FLYWAY ZIPLINE /GSC website or other media, without compensation. 

(11) BY EXECUTING THIS RELEASE, I ACKNOWLEDGE THAT I HAVE READ THIS RELEASE, UNDERSTAND THE CONTENTS HEREOF, I CERTIFY THAT I HAVE FREELY AND VOLUNTARILY EXECUTED THIS RELEASE. I FURTHER ACKNOWLEDGE THAT, BUT FOR THE EXECUTION OF THIS AGREEMENT AND AGREEING TO BE BOUND BY THE TERMS HEREOF, THE GSC WOULD NOT AUTHORIZE ME TO PARTICIPATE IN THE FLYWAY ZIPLINE.

NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN

READ THIS FORM COMPLETELY AND CAREFULLY

YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY - FLYWAY ZIPLINE. YOU ARE AGREEING THAT, EVEN IF THE GSC USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM THE GSC IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THIS ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE GSC HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS RELEASE.


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
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*
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last 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.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle 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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