-Customer Information-

Name____________________________ DriverísLicense#_______________________
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 River Canoe and Kayak.

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 River Canoe and Kayak 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 River Canoe and Kayak 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 River Canoe and Kayak or its affiliates, as a result of my participation in these activities. In addition, I hereby release and discharge Rainbow River Canoe and Kayak, and its affiliated organizations from all actions, claims or demands that 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 RIVER CANOE AND KAYAK 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_____
Noo Paddles_____ Yak Paddles_____ Ctr. Seats_____ Dive Flags_____ Departure_____