I accept full responsibility for my actions as a
participant in the activities of Action Rafting Co.
Inc. I agree to accept and assume all of the risks
existing in this activity. My participation is purely
voluntary and I elect to participate in spite of these
risks. In consideration for the services of Action
Rafting Co. Inc., its officers, employees, agents,
or volunteers, I hereby agree to release Action
Rafting Co. Inc. from liability resulting from any
physical or mental injuries sustained. I understand that
guiding a raft requires training, skill, and experience
in water currents and conditions and that good river
skills and first aid combined cannot prevent risk or
possible injury.
I acknowledge that Action Rafting Co. Inc. has
provided me with the necessary and appropriate
information, training, equipment, and skilled personnel
so that I am prepared for events that could occur. I
understand that rafting has inherent risks that could
lead to serious emotional and physical injuries that
could be fatal. Following is a list of some, though not
all, risks that could be involved:
Weather
Water conditions and currents
Contaminated water
Hypothermia
Insects and wildlife
Difficult terrain or walking conditions
Falling out of the boat or falling into the water
Hitting or being hit by a piece of equipment
Colliding with or being pinned by natural or
man-made objects
Improper First Aide and rescue (Good Samaritan law)
My own or others attempt to exceed rafting skills
My own or others failure to follow instructions
provided by Action Rafting Co. Inc.
My own or others improper use of equipment
Equipment failure
Vehicle or pedestrian accidents while being
transported on Action Rafting Co. Inc.
vehicles.
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:
Being under the influence of alcohol or drugs.
Refusal to adhere to safety requirements or
generally not cooperating with Action Rafting Co.
Inc. personnel.
Less than appropriate age or size for existing
river conditions.
I certify that everyone on whose behalf I’m 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.
Print name clearly:
__________________________________
Signature: _____________________________________
Address: ___________________________________ City:
__________________________
State: ______ Zip:________
Phone: ______________________ email:
_________________________________
In consideration of
________________________________________ (please print
minor’s 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.
Parent/Guardian Signature:
________________________________________
Emergency contact number:
_______________________________
Minor Signature:
_____________________________________
