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Adventures by the Sea, Inc.

299 Cannery Row, Monterey, CA 93940 (831) 372-1807

Activity Waiver and Acknowledgement of Financial Liability

 

Acknowledgement of Risks, Assumptions of Risk and Responsibility, and Release of Liability

WARNING: There are significant elements of risk in any adventures, sports or activity associated with leadership training, risk-taking, team building initiatives or ropes course activities, whether conducted in the outdoors or in classrooms (referred to herein as “activity”) and the use of any related equipment. Although, we have taken reasonable steps to provide you with appropriate equipment and/or skilled instructors so you can enjoy an activity for which you may not be skilled, we wish to remind you this activity is not without risk. Certain risks cannot be eliminated without destroying the unique character of the activity. The same elements that contribute to the unique character of the activity can be causes of loss or damage to your equipment or accidental injury, illness, or in extreme cases, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for this activity, but we do think it is important for you to know in advance what to expect and to be informed of the inherent risks.

ACKNOWLEDGEMENT OF RISKS: I acknowledge that the following describes some, but not all of those risks: 1) Falls or collisions; 2) cold weather and heat related injuries and illnesses; 3) natural hazards including but not limited to inclement weather, lightning, wind gusts, severe and/or  varied wind, temperature or weather conditions; 4) balance, coordination, physical capabilities and ability to follow instructions; 5) equipment malfunctions; 6) the actions of others; and 7) physical/mental or psychological stress, fatigue, chill and/or dizziness, which may diminish reaction time and increase the risk of accident.

I UNDERSTAND THE DESCRIPTION OF THESE RISKS IS NOT COMPLETE AND THAT OTHER UNKNOWN OR UNANTICIPATED RISKS MAY RESULT IN INJURY, ILLNESS OR DEATH.

EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY: My participation in this activity is purely voluntary. No one is forcing me to participate. I elect to participate in spite of the risks. I am capable of participating in the activity and using the equipment. Therefore, I agree to assume full responsibility for myself, including any minor children for which I am responsible, for bodily injury, accidents, illness, death, or loss of personal property, and any related expenses. I acknowledge that I may decline to participate in any activity. Any participation will be voluntary.


I assume the risk(s) of personal injury, accidents, any or illness, including but not limited to sprains, torn muscles or ligaments, fractured or broken bones, eye damage, cuts, wounds, scrapes, abrasions or contusions; dehydration, drowning, oxygen shortage (anoxia) or exposure; head, neck or spinal injuries, bite or attack by animal, insect, or marine life; allergic reactions; shock, paralysis or death.

AUTHORIZATION: I hereby authorize any medical treatment deemed necessary in the event of any injury while participating in the activity. I either have appropriate insurance, or in its absence, agree to pay all costs of rescue and/or medical services as may be incurred on my behalf. I agree that any film or photographs of me, as participant, become your property and may be used for promotional or commercial purposes.

RELEASE: In consideration of services or property provided, I for myself and any minor children for which I am parent, legal guardian or otherwise responsible, any heirs, personal representatives or assigns, do hereby release:

ADVENTURES BY THE SEA, INC.,

its principals, directors, officers, agents, employees and volunteers, and each and every land owner, municipal and/or government agency upon whose property an activity is conducted, from all liability and waive any claim for damages arising from any cause whatsoever (except that which is the result of gross negligence).

I HAVE READ THE FOREGOING WARNING, ACKNOWLEDGEMENT OF RISKS, ASSUMPTION OF RISK AND RESPONSIBILITY, AND RELEASE OF LIABILITY. I UNDERSTAND THAT BY SIGNING THIS DOCUMENT I MAY BE WAIVING VALUABLE LEGAL RIGHTS.

 Today's Date: January 15, 2025 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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 Information

List all allergies to plants, insect or medication

List medications currently being used.

Describe any existing condition or prior injury which may limit your participation
Do you wear eyeglasses or contact lenses?*
Yes
No
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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