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World Barefoot Center

3915 Conine Drive East

Winter Haven, FL 33881

WATER SPORTS PARTICIPATION

LIMITED RELEASE FROM LIABILITY - MINOR CHILDREN (<18)

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. YOU ARE AGREEING THAT, EVEN IF THE RELEASED USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE VOIDED OR ELIMINATED. BY SIGNING THIS FORM  YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM THE RELEASED 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 THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE RELEASED HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IN YOU DO NOT SIGN THIS FORM. 

 

EFFECT OF FLORIDA LAW ON A LEGAL GUARDIAN'S ABILITY TO WAIVE CLAIMS OF NEGLIGENCE ON BEHALF OF COMMERCIAL ENTITIES FOR INJURIES, DEATH OR LOSS EXPERIENCED BY THEIR MINOR CHILDREN

This supplemental waiver for minor children does not waive your minor child's ability to recover against the Released for injuries, damages, or other loss occurring to the minor child, brought on behalf of the minor child by either you as natural guardian, personal representative, or guardian ad litem based on the negligence of the Released. By intialing this section and signing the waiver below, you are knowingly and voluntarily agreeing, and expressly acknowledging, that you have read the statement above regarding the waiver of your ability, as well as that of your minor child or his/her representative, to recover against the Released for any PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. As provided by Fla. Stat. S744.301(3)(b) (2012), the term natural risk or otherwise construed as an "inherent risk" of the activity means those dangers or conditions, known or unknown, which are characteristics of, intrinsic to, or an integral part of the activity and which are not eliminated even if the activity provider acts with due care in a reasonably prudent manner. The term includes, but is not limited to the failure by the activity provider to warn the natural guardian or minor child or an inherent risk; and the risk that the minor child or another participatn in the activity may act in a negligent or intentional manner and contribute to the injury or death of the minor child. The scope of this supplemental waiver shall be coextensive with that of the Adult Participant Waiver to the fullest extent allowed by state law. 

NATURAL GUARDIAN'S ACKNOWLEDGEMENT OF LIMITED RELEASE ON BEHALF OF MINOR CHILD

Your signature below reflects your express assent to be bound to the terms of this supplemental agreement for your minor child. Your signated also represents your attestation to being the natural guardian of the minor child(ren) listed below, and possessing the legal authority to sign this agreement on their behalf. Please carefully review each section again and ensure that you fully understand the implications of this agreement. 

**Failure of less than all natural guardians to sign this form on behalf of a minor child does not constitute a basis for waiver of the limitations granted herein**

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*

Confirm Email*
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*

Last Name*

Relationship*

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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