Loading...

Community Leadership Center Agreement, Waiver, & Release 


I, recognize that I will be participating in activities at the Community Leadership Center that may involve physical movement and challenges, balance, nerf weapons (hitting and being hit by), verbal/physical interaction with “opponents”, climbing, falling, and slight elevation off the ground. I understand that these and other team builder activities may present a wide variety of risks to the participant (in this case, myself) most of which are not easily foreseeable, that could result in loss & damage and - in extreme cases - injury or death. These adverse conditions may include, but are not limited to; steep, uneven, and difficult terrain, hard objects, tripping or slipping, swinging ropes and handholds, and other participants disregard of safety rules. I understand that Thrive Outdoors and its associates have taken precautions to mitigate accidents and I will not hold Thrive Outdoors or any of its associates responsible for any such accidents. I understand I am not to enter onto any equipment or apparatus until specifically told to do so by staff (of the Community Leadership Center) and that I am responsible for communicating with staff if I do not understand safety expectations.

I understand that Thrive Outdoors cannot be held responsible for injury, loss, or death caused by my disregard for rules or procedures, both written and verbal, given by Thrive Outdoors. I have been instructed to follow the direction and guidance of Thrive Outdoors instructors / guides to the best of my ability at all times. In the absence of Thrive Outdoors instructors / guides I will take direction from staff or leadership. 

I understand that Thrive Outdoors has put much care and planning into these outings and will do their best to treat me with respect and concern for my wishes regarding decisions pertaining to my wellbeing and medical care should I need it. I further acknowledge that a medical release must be signed by me before I may participate in any all day or overnight activities with Thrive Outdoors (more than 10 hours of consecutive programming). 

I am aware that there are risks involved in the activities associated with Thrive Outdoors programming and I have elected to participate to the fullest with all aspects of the package and course curriculum *purchased, to include any transportation required for said activities. I understand the rules and regulations, risks, and best practices for these activities. By signing this form I am agreeing to all terms and conditions and stating that I release Thrive Outdoors and any of their partners from liability for any injury, loss, damage, or death occurring in conjunction, directly or indirectly, with any Thrive Outdoors activities I elect to participate in.  

I realize that insurance protection is my choice and is my responsibility to obtain.

My signature below signifies that I understand there are risks involved in the activities I am signing up for, that everything on this form is, or has been made, clear to me, I have filled it out truthfully to the best of my knowledge, and I agree with all sections. I am entering into this agreement with the knowledge that I am participating at my own risk.

Thrive Outdoors CLC - 190 Elm Street, Manchester, NH 03102  603-625-6600

May 21, 2025

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
First Name*
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
Last Name*
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*
Check to receive information, news, and discounts by e-mail.
Image / Media Release:
My image, or video of me, may be used in brochures, videos, or other promotional means by Thrive Outdoors.*
Yes
No
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*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!