Rainbow Connection Shuttle Service

Name____________________________ Driver’sLicense#_______________________
Phone____________________________E-mail________________________________
Address______________________City_________________State____Zip___________

-Release of Liability-
I, ____________________________________,
(Please print your first and last name.)
Hereby acknowledge that I have voluntarily applied to participate in CANOEING or KAYAKING with Rainbow Connection Shuttle Service.

I AM AWARE THAT THESE ACTIVITIES ARE HAZARDOUS ACTIVITIES, AND AM (OR MY CHILD IS) VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH.

Initials: ____________________ Under 18, Parent Initials: ___________________

As lawful consideration for being permitted by Rainbow Connection Shuttle Service or one of its affiliated organizations to participate in these activities and use their facilities, I hereby agree that I, my heirs, distributees, guardians, legal representatives and assigns will not make a claim against, sue, attach the property of, or prosecute Rainbow Connection Shuttle Service and/or any of its affiliated organizations for injury or damage resulting from the negligence or other acts, howsoever caused, by any employee, agent or contractor of Rainbow Connection Shuttle Service or its affiliates, as a result of my participation in these activities. In addition, I hereby release and discharge Rainbow Connection Shuttle Service, and its affiliated organizations from all actions, claims or demands I, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter have for injury or damage resulting from my participation in these activities.

I HAVE CAREFULLY READ THIS AGREEMENT
AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND RAINBOW CONNECTION SHUTTLE SERVICE AND/OR ITS AFFILIATED ORGANIZATIONS, AND I HAVE SIGNED IT OF MY OWN FREE WILL.

____________________________________          ______________________________ PARTICIPANT SIGNATURE:                              WITNESS:
 

______________________________________________                                          PARENT SIGNATURE:(If participant is under age 18.)                                                        
                                                                                                                                   

Release Dated: _______/_______/_______
________________________________________________________________________
Office Use Only: Rainbow River____Withlacoochee River_____ PFD's___
Canoes_____ Kayaks____S-O-T Kayaks____Tandems_____ S-O-Tandems___
Canoe Paddles___ Kayak Paddles___ Center Seats___ Dive Flags___