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KAYAK PROGRAM

AGREEMENT & WAIVER


In consideration of participation in the kayaking program, (the “Program”) of Massachusetts Audubon Society, Inc. (“Mass Audubon”), the undersigned hereby acknowledges and agrees that:


1. I will follow all safety instructions provided by Mass Audubon guides and will wear a PFD for the entirety of any trip in a kayak.


2. I understand and meet the physical requirements needed for this program, including, but not limited to, having an ability to swim; the physical ability and stamina to paddle and control a kayak; the physical ability to get into and out of a kayak; and have no known ailments or conditions that will preclude my safe ability to participate in the Program.


3. I acknowledge that kayaking entails both known and unanticipated risks that could result in physical or emotional injury, death, or damage to myself, to property, or to third parties.


4. I hereby release and forever discharge, and agree to indemnify and hold harmless, Mass Audubon and its officers, directors, employees, volunteers, and agents (collectively, the “Releasees”), and each of the Releasees, from and against any and all liabilities and obligations of every kind and description arising out of, or in connection with, my participation in the Program, including, but not limited to, injury (including death) to my person or others or damage to, or loss of, my or other person’s property.

Photo Release

Massachusetts Audubon Society, Inc. (“Mass Audubon”) uses images and sounds of persons enjoying its sanctuaries and participating in its programs and events in support of its educational and charitable mission. Mass Audubon does not use a person’s likeness, or identify any person by name, unless it has received specific written permission to do so.

In consideration of the above, I hereby grant Mass Audubon permission –

(1) to photograph, film, and make audio and/or video recordings of, me, and

(2) to use and display the photograph(s), film(s), and audio and/or video recording(s) of me and my likeness, voice, and appearance, in whole or in part, in Mass Audubon’s website, archives, and promotional and/or informational material (including, but not limited to, newsletters, brochures, advertisements, and newspaper articles), and in any and all media, broadcast, or digital format, including electronic, radio, internet, and television, throughout the world.

I hereby waive and release any right to compensation for, or ownership of, such photograph(s), film(s), and audio and/or video recording(s) of me and the above uses of them by Mass Audubon.

I have read this consent and release and agree to its terms and conditions.

A parent or guardian must sign this consent and release on behalf of a child under the age of 18.

If a parent or guardian participates in a program or event with his or her child, signing on behalf of the child will also indicate that the parent or guardian also consents to the terms and conditions of this consent and release for him or herself.

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First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
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Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
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Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*

Participants must be 12 years or older to participate.


Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those 12 - 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*
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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