Loading...

E STREET SURF SCHOOL LLC LESSONS/RENTAL FORM

RELEASE AND WAIVER OF LIABILITY

 

WARNING: PLEASE READ THIS AGREEMENT CAREFULLY. BY AGREEING TO THIS LIABILITY WAIVER AND RELEASE AGREEMENT (THE “AGREEMENT” OR “RELEASE”), YOU WILL WAIVE CERTAIN LEGAL RIGHTS IN ACCORDANCE WITH THIS AGREEMENT/RELEASE AND AS PROVIDED BY LAW. PARENTS/GUARDIANS OF MINORS UNDER 18 MUST SIGN THIS FORM.

 

This Release is executed on this day of June 9, 2025 (the “Effective Date”) by and between on behalf of [the undersigned] (the “Participant”) and E STREET SURF SCHOOL, a limited liability company, E STREET SURF SCHOOL LLC.

 

1. Acknowledgement of Risk: I understand and acknowledge on behalf of myself and/or any minor children for whom I am responsible, that certain risks are typically involved with any aquatic activity, including but not limited to collisions, falls, drowning, and equipment failure; that I and/or my minor child may suffer accidents or illnesses in remote places where there are no available medical facilities; and that no warranty of any kind, express or implied, is being made. I also realize that participation in any aquatic activity, including but not limited to surfing, bodyboarding, paddling boarding, and other related aquatic activities (collectively, “Activities”) can result in personal injury, accidents and/or illness including but not limited to broken bones, head injuries, paralysis, serious injury and/or death, as well as damage to or loss of personal property. Exposure to the elements and temperature extremes may result in frostnip, frostbite, heat exhaustion, heat stroke, sunburn, hyperthermia, and dehydration. I acknowledge on behalf of myself and/or my minor child that I have been fully advised of the dangers inherent in participating in the abovementioned Activities. I understand the description of these risks is not complete and unknown or unanticipated risks may result in injury, illness, or death.

 

2. Express Assumption of Risk and Responsibility: In consideration of being able to participate in the Activities, I, for myself and any minor children for whom I am a parent, confirm that I and/or my minor child are physically and mentally capable of participating in full in the Activities. I and/or my minor child participate willingly and voluntarily in the Activities and voluntarily assume full responsibility for personal injury, accidents, or illness including death, as well as damage or loss of personal property. I am aware that there is a risk of negligence by E STREET SURF SCHOOL LLC (“Released Party”), and/or each of its officers, directors, agents, employees, agents, volunteers or assigns (collectively, “Agents”), including the failure by the Released Party and/or its Agents to safeguard or protect me/us from the risks, dangers, and hazards of the Activities. I on behalf of myself and/or my minor child freely accept and fully assume all risks, dangers and hazards associated with participating in the Activities and the possibility of loss, personal injury or death resulting therefrom.

 

3. Release: In consideration of participating in the Activities, I, on behalf of myself and/or my minor child, hereby agree as follows: 

a. To waive any and all claims, liabilities, actions, damages, penalties, suits, costs or expenses of any nature whatsoever, in law or equity (collectively, “Claims”), that I and/or my minor child has or may in the future have against E STREET SURF SCHOOL LLC and/or its Agents, the TOWN OR RYE and THE STATE OF NEW HAMPSHIRE and/or its Agents, and to release the Released Party and its Agents from any and all Claims that I and/or my minor child may suffer or that my next-of-kin may suffer as a result of my participation in any of the Activities, to the extent provided by law.

b. To hold harmless and indemnify the Released Party and its Agents, from any and all Claims relating to any property damage or personal injury to any third party resulting from my participation in the Activities. This Liability Waiver and 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.    Consent To Medical Care. I (and, if applicable, my Parent) authorize each of the Released Parties to call for medical care for me to transport me to a medical facility at my expense if medical attention is needed. I (and, if applicable, my Parent) also authorize a physician or other medical provider or facility to provide me with any emergency medical/surgical care. I (and, if applicable, my Parent) acknowledge and agree that none of the Released Parties is under any legal obligation to render assistance to me.

 

5.    Indemnity. On behalf of myself and each of my successors, heirs, and assigns, Participant (and, if applicable, my Parent) agree to defend (at the Company’s request), indemnify and hold harmless each of the Released Parties from and against any and all Released Claims, and any and all third parties’ Claims, arising from or in connection with: (a) any breach or alleged breach of this Release; (b) my participation in the Activities, including, without limitation; (i) any Injuries to me; (ii) any Injuries to third parties directly or indirectly arising from my participation in the Activities; and (iii) and any other loss or damage that I may directly or indirectly cause to any real or personal property.

 

6.    Governing Law. This Agreement shall be governed by and interpreted solely in accordance with the laws of the State of New Hampshire and no other jurisdiction.

 

By signing this Agreement, I acknowledge and represent that:

(1) I have read the above waiver and release, understand it, and sign voluntarily;

(2) I am over 18 years of age and am of sound mind;

(3) I, and/or my minor child, have no known physical or mental condition that would increase the likelihood of serious injury from such participation; and

(4) In case of emergency, I give permission to have myself and/or my minor child taken to and treated at the nearest available medical facility.

 

If the participant is a minor, the undersigned parent or legal guardian warrants and represents that this agreement, its significance and the assumption of risk, has been explained to and understood by the minor child or ward. I hereby declare, under penalty of perjury, that I am the parent or legal guardian of the named participant.


TOWN OF RYE RELEASE AND WAIVER OF LIABILITY

CAREFULLY READ EVERY LINE OF THIS RELEASE AND WAIVER OF LIABILITY. IT PREVENTS YOU FROM BRINGING LIABILITY CLAIMS AGAINST THE TOWN OF RYE AND ITS OFFICIALS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES.

The Town of Rye has issued permits for businesses to rent or issue recreational and water sports equipment, including but not limited to surfboards, paddle boards, paddles, boogie boards, wetsuits, and leashes, and to provide related lessons, group activities and learning camps on or about Town beaches and in the ocean. These are risky and dangerous activities for which the Town of Rye shall have no liability.

 

In consideration of renting, borrowing or using recreational and water sports equipment, and/or participating in related classes, lessons, group activities or camps, the undersigned:

 

1. Releases, waives, discharges, covenants not to sue, indemnifies and holds harmless the Town of Rye, its officials, employees, agents, volunteers and representatives (hereinafter “Releasees”) from any and all liability to the undersigned, and his/her representatives, heirs, and successors in interest (hereinafter “undersigned”) for any and all loss, injury, illness or damage, and any claim or demands therefore on account of death, injury or illness of the undersigned or damage to the property of the undersigned whether caused by the negligence of the Releasees or otherwise, arising from or related to the undersigned’s possession, handling or use of rented or borrowed recreational and water sports equipment and/or undersigned’s participation in any related classes, lessons, group activities or learning camps.

 

2. Assumes full responsibility for all risks of bodily injury, personal injury or property damage, including but not limited to death, paralysis, brain injury, heart attack, cardiovascular injury, stroke, aneurysm, broken bones, torn tendons or ligaments, torn muscles, spinal injury, damage to organs, disease, infection, emotional distress, illness, and any other physical or emotional injury, medical or psychiatric condition or complication of any kind whatsoever, due to any cause, including the negligence of Releasees or otherwise, arising from or related to the undersigned’s possession, handling or use of rented or borrowed recreational and water sports equipment and/or undersigned’s participation in any related classes, lessons, group activities or learning camps.

 

3. Represents and warrants: (a) that he/she acknowledges that possession, handling and use of rented or borrowed recreational and water sports equipment and/or participation in any related classes, lessons, group activities or learning camps, like any form of strenuous recreational or water sports activity, involves the risk of serious bodily and psychiatric injury, death and property damage; (b) that some of the risks of harm include, but are not limited to, intense physical activity, exhaustion, dehydration, heat stroke, sunburn, lifting or controlling the equipment, inexperience, lack of skill, inadequate instruction, negligent permitting, regulation, supervision, control, response, prevention or oversight, slippery surfaces, obstacles which might cause trip and falls, pre-existing health problems, carelessness and negligence of Releasees, equipment failures, design defects, adverse weather conditions, dangerous wind and water conditions, lightning, rip currents, the equipment itself, other persons swimming and using water sports equipment, boats, marine life, the ocean floor, rocks and any other risk of harm whatsoever that one might encounter in relation to possessing, handling or using recreational and water sports equipment at the beach and in the ocean and/or participation in any related classes, lessons, group activities or learning camps; (c) that he/she has read every line of this Release and Waiver of Liability carefully and had an opportunity to review it with legal counsel; and (d) that he/she is in good health and has no preclusive medical condition.


Today's Date: June 9, 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 Driver's License / ID Card
Driver's License / ID Card Number*
Issuing State*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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!