This form must be read, acknowledged, and signed by all Participants, adults and minors (persons under 18 years of age), AND by a parent or court-assigned, legal guardian (each referred to as “Parent”) of a minor Participant. Parent signs for himself or herself and on behalf of the minor child. No applicant may participate in any service or tour unless this form is read and acknowledged by signature of the Participant and/or Participant’s Parent. The parties to this agreement are DJHM Enterprises LLC DBA Captain Zipline (“Provider”) and the persons signing below (“Participant” and “Parent”).
I. Express Assumption of Risk Associated with Zip Lining
I am aware that Provider offers RECREATIONAL services and tours. My participation and/or my child’s participation in Provider’s services, including but not limited to ziplining, aerial trekking, via ferrata, climbing, hiking (“Tours”), involves RECREATIONAL activities including, but not limited to: traversing uphill slopes and uneven terrain; walking, standing on, scrambling over, or climbing on loose gravel, rock and uneven terrain; climbing; standing or walking near unguarded slopes and steep cliffs; swinging with the use of cables, harnesses, and ropes at heights up to 200 feet above the ground; moving and landing at high speeds with the use of cables, ropes, and harnesses; and traveling by vehicle on paved roads and on unpaved rough, dirt roads to and from the premises of Provider, either in my vehicle or in a vehicle provided by Provider. I AM/WE ARE AWARE THAT THESE ACTIVITIES MAY BE DANGEROUS, AND THAT PARTICIPATION IN THESE DANGEROUS ACTIVITIES CAN RESULT IN PROPERTY DAMAGE, SERIOUS INJURY, OR DEATH. IF SIGNING AS A PARENT, I HAVE INFORMED MY MINOR CHILD OF THESE RISKS.
I have been informed of the inherent hazards and risks associated with my participation and/or my child’s participation in Provider’s Tours, which can include, in rare cases, serious injury or death. These hazards and risks include, but are not limited to the following:
Read carefully. After reading, Participant shall initial in the space provided; Parents shall initial for their minor child).
Equipment used by me or others could fail or malfunction;
I could fall while walking, standing, traversing challenge elements or ziplines, scrambling on loose terrain, climbing, or using ziplining, aerial trekking, or via ferrata equipment;
My clothing, hair, or hands could become caught in zipline, aerial trekking, or via ferrata equipment, obstacles, ropes, or cables; I could injure my hands by grabbing cable, ropes, rock features, or challenge obstacles;
While using zipline, aerial trekking, climbing, or via ferrata equipment, I could suffer injuries while traversing obstacles or ziplines by colliding with the ground, a support column, objects, another participant, or a Guide, or in some other fashion;
This activity takes place outdoors, and therefore I will be exposed to risks associated with exposure to elements, including sun, wind, rain, or snow, lightning, excessive heat, hypothermia, and encountering objects either natural or human-made, including but not limited to loose, uneven or slippery rock, falling rock or debris, trees, and plants;
As a result of my own negligence, or the negligence of Provider and Provider’s employees, agents, or assigns (“Agents”), or of other participants, I may fall, collide with others or objects, and/or suffer serious injury or death;
Provider and its Agents may negligently misjudge weather or terrain, or the expertise or comfort level of participants; Provider and its Agents may improperly or negligently use, adjust, or check harnesses, cables, ropes, lanyards, connectors, belay devices, or other equipment; Provider and its Agents may improperly or negligently fail to provide adequate supervision of participants, or adequate training for participants; Provider and its Agents may improperly or negligently operate a motor vehicle in which I am an occupant;
I will travel on paved roads and on rough, unpaved dirt roads to and from the premises of Provider, in my own vehicle or in a vehicle owned or leased by Provider;
I may encounter adverse plants, insects, reptiles, birds, deer, and other animals;
While participating in Provider’s Tours, I will be in a remote location where there are no available medical facilities and where medical attention may be more than one hour away;
I or others may suffer from dehydration, heat, fatigue, chill, and/or dizziness, which may diminish my/our reaction time and increase the risk of accident, injury or loss.
I understand the description of these hazards risks is not complete, and that unknown or unanticipated hazards or risks may result in injury, illness, or death.
II. Release of Liability for Negligence, Waiver of Claims, and Indemnity Agreement
In consideration for being permitted to participate in the activities described above and related activities and/or use of its facilities, I/we the undersigned Participant(s), and the Parent of a minor Participant (for himself or herself and on behalf of the minor Participant), agree as follows:
1. I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL PROPERTY DAMAGE, INJURY, DISABILITY, DEATH, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as “Releasees” or “Released Parties”: Provider and its owners/members, employees, subcontractors, Agents, and assigns;
2. I understand that Provider’s Agents will accompany me while I participate in Tours and will direct and assist me and other participants in our activities. I further understand that Provider’s Agents may not be employees or contractors of Provider. I HEREBY RELEASE PROVIDER ITS AGENTS AND OTHER RELEASEES, AND HOLD THEM HARMLESS FROM ANY AND ALL LIABILITY OF ANY KIND FOR PROPERTY DAMAGE, INJURY, OR DEATH arising from my participation in Tours, whether caused by NEGLIGENCE OR OTHERWISE;
3. I accept full and complete responsibility for any expenses that may be incurred by Provider for any illness or injury that may result from my participation in Provider’s Tours and services, including the costs of evacuation, hospitalization, and medical treatment and any sums payable to anyone by reason of any injury or loss of life that I may sustain through my participation in Provider’s Tours or services, and for all expenses associated with the defense of any such claims.
4. I, on behalf of myself and my estate, heirs, successors, survivors, assigns, guardians, agents, and personal representatives, hereby agree and warrant that: a) I waive any and all claims against the Provider, its Agents and other Releasees; b) I will not sue or assert any claim or cause of action, whether before a court of law or otherwise, against Provider, its Agents, and other Releasees; c) I will defend, indemnify, and hold harmless Provider, its Agents, and other Releasees for injuries, death, or property damage caused by or related to my participation in Tours whether caused by active or passive negligence of Provider, its Agents or other Releasees or otherwise; d) if I take legal or other action that is contrary to the terms of this Agreement, I will be responsible for the payment of all attorney fees and costs incurred by Provider, its Agents, and other Releasees; e) I agree that if I bring legal action of any kind arising out of my participation in Tours, I will bring such legal action only in courts in the State of Colorado. I agree that Colorado courts shall have exclusive jurisdiction over any such legal action, and I hereby waive my right to bring any such legal action in courts or bodies in any other state or jurisdiction.
III. Photographic, Video, and Media Release of Participant Likeness
Provider, its Agents, and other Releases reserve the right to use audio, video, or other photographic images of or by Participant for future marketing, educational or other purposes, and Participant/Parent hereby consent to such use, without compensation.
By entering into this Agreement, I am not relying on any oral or written representation or statements made by Provider, its Agents, or other 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 FOR NEGLIGENCE, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Today's date: May 13, 2021