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Action Rafting Co. Inc. - Liability and Assumption of Risk
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Trip Date: ________________________________ River: ______________________________________________ |
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I hereby agree to follow all rules and instructions given by Action Rafting Co. Inc. personnel concerning participation in any of their services. Action Rafting Co. Inc. reserves the right to refuse service to any person. Following are some, though not all, reasons that a person could be denied participation: |
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| I certify that everyone on whose behalf Im signing is physically and mentally capable of participating in Action Rafting Co. Inc. activities. I agree that Action Rafting Co. Inc. may use videos or photographs of trips for its promotional or commercial use. I have read this release of liability and assumption of risk agreement and fully understand the terms. I understand that I have given up substantial rights by signing this agreement and sign it freely and voluntarily without any inducement. |
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| Print name clearly: ___________________________________________________________________________ |
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| Signature: __________________________________________________________________________________ |
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| Address: ___________________________________________________________________________________ |
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| City: _____________________________________State: _________________________ Zip: _______________ |
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| Phone: __________________________email: _____________________________________________________ |
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| Parents or Guardians additional indemnification: |
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In consideration of ________________________________________ (please print minors name) being permitted by Action Rafting Co. Inc. to participate in its activities and to use its facilities, I further agree to defend, hold harmless and indemnify Action Rafting Co. Inc. from all claims which are brought by or on behalf of said minor, and which are in any way connected with such use of participation by minor. It is further agreed that in the event of injury or emergency involving the minor, Action Rafting Co. Inc. is authorized to use its sole discretion to summon and consent to emergency or medical assistance and that any associated costs shall be the sole responsibility of the undersigned. |
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| Parent / Guardian Signature: __________________________________________________________________ |
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| Emergency contact number: ___________________________________________________________________ |
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| Minor Signature: ____________________________________________________________________________ |
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