Rafting Liability Release
[City, State, Zip]
City: ______________________________________ State: _____________ Zip Code: ________________________
Phone Number: ________________________________________________________________________________
Email Address: _________________________________________________________________________________
I the above listed and undersigned do hereby acknowledge, understand and agree to the following:
The risks of injury from the activities that are involved in this program are significant and may include the potential for permanent paralysis and death
and skills, equipment and personal discipline may reduce such a risk the risk of serious injury does exist.
I am knowingly and freely assume all such risks that are both known and unknown this includes events arising from the negligence of the releasees or any
others and I am assuming full responsibility for my participation.
I am willingly agreeing to comply with all the stated and customary terms and conditions for participation and I understand that I must wear proper shoes
or booties and an approved flotation device at all times while I am rafting. I am presently in good health and I understand that physical exertion may be
required and that I have no known physical disabilities or health problems that will present any risk to my participation in the program. If I do have any
unusual significant hazard during my participation I will promptly remove myself from participation and bring it to the attention of the Company at once.
I for myself and on behalf of my heirs and personal representatives and next of kin do hereby release, indemnify, and hold harmless the Company, their
owners, officers and or employees and other participants, subcontractors, affiliates and sponsoring agents with respect to any and all injury disability,
death or loss or damage to person or property that is associated with my participation, regardless if it is arising from the negligence of the releasees to
the fullest extent that is permitted by law.
All claims and or disputes that arise from my participation in this program shall be located in the local court in the town of _________________ or in the
Supreme Court of the State of _____________________.
I have read this Release of Rafting Liability and fully understand the terms and conditions with the understanding that I have given up substantial rights
by signing it and sign freely and voluntarily without inducement.
Signature: ___________________________________________________________________ Date: ___/___/_____