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Sea Kayaking Trip Release of Liability

Participant Agreement & Medical Form

PO Box 3537

Courtenay, BC

Canada V9N 6Z8

1.800.665.3040 or 250.338.2511

RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT (hereinafter referred to as the "Release Agreement")

BY SIGNING THIS DOCUMENT YOU WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT

PLEASE READ CAREFULLY!

TO: West Coast Expeditions Ltd., Her Majesty the Queen in the Right of the Province of British Columbiaand its directors, officers, employees, instructors, guides, agents, representatives, independent contractors, subcontractors, suppliers, sponsors, successors and assigns (all of whom are hereinafter referred as "the Releasees")

DEFINITION
In this Release Agreement Canoeing and Kayaking (hereinafterthe Activities) shall include all activities, events or services provided, arranged, organized, conducted, sponsored or authorized by the Releasees and shall include, but is not limited to: ocean kayaking, kayaking in surf or moving water, still water and ocean canoeing; wilderness travel, hiking, camping and boat or float plane travel; rental of canoes and kayaks (hereinafter the boats) and other equipment; orientation and instructional courses, seminars and sessions; and all travel, transport and accommodation.

ASSUMPTION OF RISKS
I am aware that the Activities involve many risks, dangers and hazards including, but not limited to: accidents which occur during transportation or travel to and from the put in; slip and falls while getting into or out of the boats; overturning of the boats; loss of balance; impact, collision with or entrapment by trees, logs, deadfall, boats or equipment; hypothermia; changing and inclement weather conditions including storms, high wind, high waves, and lightning; on land or camping hazards such as falling due to uneven terrain, unstable beach logs, slippery rocks, falling branches, campfire, pressurized cooking fuels and appliances, kitchen equipment, hot liquid; encounters with domestic or wild animals; exposure to communicable illness or disease through travel, group interactions, surfaces, soil, food, or water; negligence on the part of other participants; and NEGLIGENCE ON THE PART THE RELEASEES, INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN THE ACTIVITIES

I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH THE ACTIVITIES AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF PERSONAL INJURY, ILLNESS, DISEASE, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT
In consideration of the RELEASEES agreeing to my participation in the Activities and permitting my use of their services, equipment and other facilities, and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged, I hereby agree as follows:

1.TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the RELEASEES AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer, as a result of my participation in the Activities, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS LIABILITY ACT, ON THE PART OF THE RELEASEES, AND FURTHER INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN THE ACTIVITIES REFERRED TO ABOVE;

2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES for any and all liability for any property damage, loss or personal injury to any third party resulting from my participation in the Activities;

3. This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity;

4. This Release Agreement and any rights, duties and obligations as between the parties to this Release Agreement shall be governed by and interpreted solely in accordance with the laws of the province where the Activities take place and no other jurisdiction; and

5. Any litigation involving the parties to this Release Agreement shall be brought solely within the province where the Activities take place and shall be within the exclusive jurisdiction of the Courts of that province.

In entering into this Release Agreement I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of participating in the Activities, other than what is set forth in this Release Agreement.

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES

Signed this day: September 28, 2021

Please select who will be participating...
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First Participant Name

First Name*

Last Name*

Phone*
First Participant Date of Birth*
First Participant Age & Gender

Age on Trip: *

Gender *
First Participant Signature*
Participant Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Would you like to be on our newsletter list?
Emergency Contact

Please select a person who will NOT be on the trip with you.


Emergency Contact's Name (someone NOT on the trip with you) *

Emergency Contact relationship to you *

Emergency Contact's Phone Number *
Accommodation and Pick-up Information

Accommodation or address for van shuttle pick-up. Please specify where you want to get picked up, if applicable (e.g. hotel, home address, location where leaving vehicle, or if otherwise N/A because driving yourself to Fair Harbour).

Phone number that we can use to reach you the night before your trip start to confirm van shuttle pick up timing (e.g., cell phone number or at your accommodations).

Please specify your tent partner(s) - single upgrade may be available upon request.

*Note: Rates are based on double tent occupancy. Alternatively, friends or families may request to have up to 3 or 4 people per tent, if available.  Please contact us to ensure you have your own tent as a solo traveller.

Kayaking Information:

We operate in a remote location where access to medical care can sometimes be difficult or delayed. Completing this questionnaire accurately will give our staff an understanding of your abilities and possible limitations. This information will remain confidential, with the exception of any medical history or allergy information which may put the group or you at risk if it is not disclosed. We will release only the information required for this purpose. In the unlikely circumstance that other information may need to be released, we will do so only with your permission.

Please select your trip:*

Please select your trip start date: *

Height in feet: (e.g. 5'9") *

Weight in lbs: (e.g. 155) *
Are you prone to sea sickness?*

What is your: 

Kayak preference?*

Note: If choosing to bring your own kayak, conditions do apply. If you haven't discussed this option with us yet, please contact us as soon as possible.      

Kayaking experience?*
Kayaking ability?*
Swimming ability?*
Medical Information

Dietary: 

We strive to offer you a delicious memorable wilderness food experience. We will do our best to accommodate dietary restrictions, but please keep in mind that we cannot guarantee our food prep areas and equipment are allergen free. If you have severe intolerances/allergies that restrict your menu options, please provide us with the necessary detailed information below.  

I cannot eat:

Please check all that apply.
Poultry
Seafood
Shellfish
Fish
Beef
Pork
Cooked eggs
Eggs in baking
Dairy
Dairy in baking
Wheat
Gluten
Nuts
Soy
Other

Please describe your dietary restrictions/preferences here, including appropriate substitutes. Also, if your dietary restriction is allergy or intolerance related, please describe the: severity, causes, symptoms, reaction, required treatment, and recovery time below (it's also helpful to know if cross-contamination is a concern):

Medical Conditions:

Do you currently have or do you have a history of the following medical conditions?

Please check all that apply, and provide further details below.
Allergies to any food
Allergies to the environment or stings
Allergies to any medication
Other allergies
Respiratory problems or asthma
Gastrointestinal disturbances
Diabetes
Bleeding/blood disorders
Heart disease or cardio vascular issues
High blood pressure
Hepatitis or other liver disease
Infections (ear, eye, bladder, kidney, etc.)
Neurological issues: seizures or other
Dizziness or fainting episodes
Urinary or reproductive tract disorders
Menstrual cramp treatment/medication
Back, knee or shoulder problems
Hearing loss or balance issues
Other bone, joint, muscle, tendon issues
Mental health treatment or counselling
Do you see a medical/physical specialist
Are you pregnant
Do you smoke
Other medical conditions (past/present)

If "yes" to any of the above, please describe the: severity, causes, symptoms, reaction, required treatment, last time it occurred or was a concern, and recovery time.

Please list any prescription/non-prescription medications (incl. Epipen/inhaler) that you intend to bring with you. List the name/remedy, reason for use, and instructions for frequency and dosage (e.g. ventolin: use as needed, or Levothryroxine: 175mg/daily)

(If you use or carry medication for a condition please ensure that your prescription is up-to-date, that you bring double the necessary supply, and that you store it in waterproof containers in two separate locations among your belongings or with one of your guides).

We strongly recommend that your Tetanus immunization be current within 10 years of your trip. Will your Tetanus be current?*

Through the Covid-19 pandemic we strongly recommend that all trip participants are vaccinated. Please indicate whether you've had your first vaccination, or are fully vaccinated, the date of your last vaccination, and which vaccine(s) you've received.

Do you exercise regularly?*

If yes, please describe type, duration, and frequency:
Insurance and Medical Coverage:

International Guests: We require you to please carry medical travel insurance while on tour with West Coast Expeditions. We also recommend trip cancellation and emergency evacuation insurance.  Please provide the name and contact details of your insurance provider(s) and your policy number(s):

Canadian Participants: Please provide your provincial health care number and details about additional travel insurance that you may carry. We recommend trip cancellation insurance. Please provide the name and contact details of your insurance provider(s) and your policy number(s):

(We recommend that, if applicable, you notify your provincial health care plan that you will be out of province)

Please note, if you paid for your trip with WCE using a credit card, you may be eligible for aspects of travel/cancellation insurance through your credit card provider.
Agreement to Disclose:

The information provided above is a complete and accurate statement of any physical and psychological conditions which may affect my participation in this trip. I realize that failure to disclose such information could result in serious harm to me and to other guests. I agree to inform West Coast Expeditions should there be any change in my health status during or prior to the start of the trip. On the basis of the background information that I have provided, and what I know or suspect about my physical and psychological health, I am fully capable of participating in this wilderness adventure trip. 

All information shared herein will be kept confidential and only used by WCE staff for trip safety, preparation, and emergency response.


I Agree to the statement above
Participation Agreement
I understand that in the event of inclement weather, or any other condition that threatens the safety of the participants, West Coast Expeditions reserves the right at any time, to alter the itinerary of the trip package or expedition, without penalty or obligation to refund any amount paid by the participants.

I understand and fully accept that West Coast Expeditions reserves the right at any time to refuse, without penalty or any obligation to refund any amount paid, continued participation in an expedition by any person who in the sole discretion of the trip guides becomes a hazard to themselves or other members of the trip or expedition.

I Agree to the statement above
COVID-19 Agreement

COVID-19 is a serious health threat, and the situation is evolving daily. The risk varies between and within communities, and affects individuals differently.  At West Coast Expeditions (WCE) we take everyone's safety seriously.  We require that all participants comply with the most current directives from the BC Provincial Health Officer, the Ka:'yu:'k't'h'/Che:k:tles7et'h' First Nations, other BC agencies, sector organisations, and associated WCE practices. 

We can recommend but not require that service providers, partners, and participants are vaccinated for COVID-19.  We cannot guarantee that there will be no potential exposure to COVID-19 during your experience with us.

We require that participants fully pass the BC COVID-19 Self-Assessment Tool questions (https://bc.thrive.health/covid19/en) within 48h before their scheduled trip and contact us with any questions or concerns. 

Once with us, participants are expected to conduct daily self-screening and immediately disclose possible COVID-19 symptoms or concerns. With early disclosure and consistent practices for hygiene, distancing, and wearing masks (when distancing is not possible/practical) we can best support health objectives to reduce the likelihood and consequences of transmission. 

If a participant is deemed to be ill, they will be isolated until such time as they can be safely removed from the trip to a testing facility and suitable accommodation. Expenses incurred for isolation, accommodation, evacuation, meals, car rentals etc. will be the responsibility of the guest. 

These measures are to respect and maximise everyone's safety and enjoyment during their time with us. 

I understand and agree to comply with WCE's COVID-19 protocols
Permission to Publish

I hereby acknowledge that West Coast Expeditions and other participants of this trip or expedition may record my participation using digital photography or video, writing, or other methods and I consent to the foregoing taking place.  I understand that privacy and anonymity will be maintained unless I provide specific consent separate from this agreement (e.g., if an image is used with me in it, my name won't appear together with the image).

I Agree to the statement above
I am not sure and would like to speak with WCE about this
You're almost done!

Once this is electronically submitted (below), you are immediately sent an email requesting that you confirm your e-signature. Please check your spam folder if you don't see this in your primary inbox within a few minutes. 

This is the final step for fully submitting this Release and Agreement! 

Thank you for helping us prepare to welcome you soon!!

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 19 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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Age & Gender

Age on Trip: *

Gender *
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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