Participant Acknowledgement of Risks –
Passenger Disclaimer Form

In consideration of the services of Coastal Express (also referred to as Flowton Pty Ltd), its agents, owners, officers, volunteers, participants, sister or subsidiary corporations including specifically but not limited to Coastal Express, employees, sales agents, subcontractors and all other persons or entities acting in any capacity on their behalf (hereinafter collectively  "Coastal Express"), I hereby agree as follows:

1. Inherent Risks: I acknowledge that any water related activity such as ocean/water rafting entails known and unanticipated risks that could result in physical or emotional injury, death, or damage to myself, to property, or to third parties. I understand and acknowledge that the enjoyment and excitement of adventure activities or scenic tours is derived in part from inherent risks incurred by activity beyond the accepted safety of life at home or in my normal day to day activities and that these inherent risks contribute to my enjoyment and excitement and are an integral reason for my participation in this activity. I understand that such risks simply cannot be eliminated without jeopardising the essential qualities of the activity. I also understand and acknowledge that failing to use or properly use safety equipment increases my risk of injury or of not surviving an accident or incident while rafting or touring.

The inherent risks associated with the rafting or scenic trip in which I am about to participate include, but are not limited to: encountering waves, white-water, changing water flows and conditions and the high possibility that I will be jolted, jarred, bounced, thrown to and fro and shaken about during rides; it is possible that I could be injured if I come in contact with other persons, breakage, or other fixed equipment necessary to the operation or outfitting of the vessel. The vessel may break down or be faulty; it is possible that loss of control of the vessel could occur resulting in collision or capsizing or sinking and that if the vessel turns over or flips I could be "washed" overboard; surfaces are slippery when wet and the vessel may be unstable so that I could slip and fall or be knocked out of the vessel even in flat or non-moving water; while in the water I may become disoriented, panicked and/or experience trauma from rocks, debris, etc; I can slip or fall during getting to and from the vessel causing injury; the vessel or any portion of it may collide with or encounter other vessel, man-made or natural objects including submerged or semi-submerged trees, rocks, branches etc.; accidents can occur getting on and off the vessel; changing weather conditions, storms or even lightning are possible; exposure to the natural elements can be uncomfortable and/or harmful and I am aware that this exposure could cause sunburn, dehydration, heat exhaustion, heat stroke, heat cramps or fatigue, some or all of which may diminish my or the other participants' ability to react or respond; I understand that exposure to cold water can result in "cold water immersion" syndrome or "cold shock," hypothermia and in extreme cases death; I may encounter dangerous wildlife, etc.; communication on the open ocean in which this activity occurs is always difficult and in the event of an accident, rescue and medical treatment may not be immediately available. I acknowledge that I AM ULTIMATELY RESPONSIBLE for my own safety during my participation in Coastal Express events/activities. 

I specifically acknowledge that, in the event I choose to consume alcohol prior to my trip with Coastal Express, I will bear complete responsibility for myself and for any damages I may cause to Coastal Express, its property or to other guests. Transportation to and from the activity is incidental to the activity. Transport and car, bus or van travel in some instances may be provided by Coastal Express and may involve errors in judgment by Coastal Express staff operating the vans, buses, cars or other transport vehicles. The vehicles and transport trailers may malfunction, break down or be poorly maintained, causing injury, accidents, delays or in the extreme case, death. Furthermore, Coastal Express Guides and Skippers have difficult jobs to perform. They seek safety, but they are not infallible. They might be ignorant of a participant's fitness or abilities. They might misjudge the weather, the elements, or the sea conditions. They may give inadequate warnings or instructions and/or I as the participant may fail to understand the safety directions due to language issues. I specifically acknowledge that decisions made by skippers/guides/staff and participants are often made in marine settings and are made based on often imprecise, momentary and subjective perceptions so that decisions are subject to errors in judgment that cannot and should not be associated with fault at a later point in time.

2. Express Assumption of Risk: As lawful consideration for being allowed to participate in activities offered by Coastal Express, I expressly agree and promise on behalf of myself and any of the children for which I am responsible, to accept and assume all the risks existing in this activity. My/our participation in this activity is purely voluntary, and I/we elect to participate in spite of the risks. I/we expressly agree and acknowledge that the terms and conditions of this Release of Liability, Waiver of Claims, Assumption of Risks and Indemnity Agreement are contractual in nature and that I/we are signing it of our own free will.

3. Personal Skill & Insurance: I certify on behalf of myself and any of the children for which I am responsible that I/we have sufficient skill and fitness to participate in the activities offered by Coastal Express. I further certify that I/we have no medical, mental or physical conditions which could interfere with my/our safety or ability to participate in these activities, or else I/we are willing to assume and bear the cost of all risks that may be created, directly or indirectly, by any such condition. I/we further certify that I/we have adequate insurance to cover any injury, damage or emergency transportation or search and rescue costs I/we may cause or suffer while participating, or else agree to bear the costs of such injury, damage or emergency transportation costs ourselves.

4. Medical Issues: I agree on behalf of myself and any of the children for which I am responsible that, in the event that Coastal Express deems it necessary to administer emergency first aid or CPR or to remove me/us from its activities or premises or from the field or to seek emergency medical care for me/us that, by signing this document, I/we are giving Coastal Express permission to: administer emergency first aid or CPR, secure emergency transport or medical care and/or disclose any medical information it may have about me/us to any health care provider which may become involved in my/our care, treatment or removal from the field. By signing this document I/we are waiving any right to object to or bring any type of action or claim against Coastal Express for its administration of emergency first aid or CPR or for securing emergency transport or medical care and/or for the disclosure of personal medical information it may have about me/us to any health related person who becomes involved in my/our care or removal from Coastal Express activities or the field.

5. Photographic Assignment: I understand that Coastal Express reserves the right to take photographic or film (of whatsoever nature) records of any or all of its activities or trips and on behalf of myself and any of the children for which I am responsible I/we hereby agree that Coastal Express may use such records for promotional and/or commercial purposes without any remuneration to me. I/we hereby assign all right, title and interest I/we may have in or to any and all media in which my name or likeness might be used by Coastal Express.

6. Release as Contract and Personal Capacity:  On behalf of myself and any of the children for which I am responsible I expressly agree and acknowledge that the terms and conditions of this Assumption of Risks Agreement are contractual in nature and that I/we are signing it of my/our own free will. I/we expressly acknowledge that I/we are not under the influence of drugs or alcohol at the time of my/our signing of this document and that there are no other impediments or reasons why I/we would lack the capacity to enter into this contract with Coastal Express.


By signing this document, I acknowledge for myself and any of the children for which I am responsible that if anyone is hurt or property is damaged during my participation in this activity, I/we may be found by a court of law to have waived my/our right to maintain a lawsuit against Coastal Express/Flowton Pty Ltd on the basis of any claim from which I/we have released them herein.



First Participant's Name

First Name*

Last Name*

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*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Parent or Guardian's Email Address


Confirm Email*
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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*
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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