RISK AWARENESS
ACKNOWLEDGEMENT, ASSUMPTION OF RISK AND RELEASE OF LIABILITY
AGREEMENT
Participant/releasor:
_________________________________ (print your name)
This agreement is
between you (participant) and Releasees named
below. It has the following purposes.
First, you are
acknowledging that you are aware there are risks inherent in participating in a
whitewater rafting trip and that these include risks that may be unanticipated.
Second, in
consideration for being allowed to participate on a whitewater rafting trip
with Rollinson Adventures, you are accepting and
assuming, to the greatest extent allowed by the law, all risks, including
unanticipated risks, of loss, damage or injury that accompany or arise from
such participation and
Third, you are releasing,
to the greatest extent allowed by the law, your right to make a claim, sue or
hold responsible those releasees described below for
any loss, damage or injury you may incur while participating on a whitewater
rafting trip with Rollinson Adventures.
Releasees: Rollinson Adventures, LLC, doing business as Rollinson Adventures, its owners, employees, officers,
agents and associates including Pacific Gas and Electric Company, Placer County
Water Agency, Sacramento Municipal Utility District, the State of
ACKNOWLEDGMENT AND ACCEPTANCE
OF RISK: I, the undersigned, hereby acknowledge that I have voluntarily chosen
to go on this whitewater rafting trip with RELEASEES. I understand certain risks are inherent in
any recreational activity and cannot be eliminated, altered, or controlled, and
these risks that contribute to the unique character of the activity can also be
the cause of injury, illness, death, and damages. I know and fully understand that a whitewater
rafting trip, whether on a raft, oar boat, kayak or any other type of vessel,
is an outdoor adventure activity in a wilderness environment with inherent risks
and hazards where serious accidents can occur, participants can die, sustain
injuries and incur property damage and/or loss.
Also, I understand that Class IV and V represent the most difficult and
dangerous levels of whitewater and recognize that the risks associated with
whitewater rafting on rivers so classified are greatly increased.
I acknowledge and willingly assume all risks
and hazards in whitewater rafting and river-related camping from the
pre-embarkation rendezvous until the conclusion of the trip, including, but not
limited to: (1) loss of control of the raft, falling in, out, or about the
raft, collision with other participants, equipment, other rafts, rocks, trees,
and any other portion of the interior of the raft, and any other man-made or
natural obstacles, whether obvious or not (2) judgment, decision-making, and
conduct of the guides (3) submersion in water, drowning (4) encounters with
animals, wildlife and insects (5) exposure to wilderness environment, extreme
temperatures, and inclement weather, remote areas, wilderness terrain,
including travel by foot or vehicle in any way related to this activity,
whether at camp or elsewhere (6) assistance in lifting and/or carrying rafting
equipment (7) rescue related injuries (8) unavailability of immediate and
appropriate medical attention in case of injury.
I further understand and
acknowledge that RELEASEES provide foot cups in some of its boats to assist
participants in stabilizing themselves.
The use of foot cups may present an increased risk of knee, ankle, or
other injuries because of their restrictive nature. Use of foot cups is totally voluntary. I understand and acknowledge that the above
list is not complete or exhaustive and that other risks, known or unknown,
anticipated or unanticipated may also exist and result in injury, illness,
disease, death or damage. My
participation in this activity is purely voluntary and I elect to do so at my
own risk.
RELEASE: In consideration for RELEASEES allowing me to
participate in this trip, I voluntarily agree to release, discharge, and hold
harmless to the greatest extent allowed by law RELEASEES for any and all claims
of liability arising out of their negligence, fault, recklessness, or any other
act or omission which causes the undersigned illness, injury, disease, death,
and damages of any nature in any way connected with my participation in this
rafting activity. I also agree to
release and discharge RELEASEES from any act or omission of negligence in
rendering or failing to render any type of rescue, emergency, or medical
services. In signing this document, I
fully recognize and understand that if I (or any minor on whose behalf I am
signing this release) am hurt, die, or my property is damaged, I am giving up
my right to make a claim or file a lawsuit against RELEASEES, even if they
negligently or by some act or omission cause injury or damage. I further agree to hold harmless, defend, and
indemnify RELEASEES from all defense costs, including attorney’s fees incurred
in connection with claims for bodily injury, wrongful death, or property damage
sustained by any minor on whose behalf I am signing under 18 years of age, or
which I may have caused to spectators or other third parties, whether negligent
or not, in the course of my participation in this activity. As a parent or legal guardian of a
participant under 18 years of age, I have read and voluntarily agree that said
minor may participate in this whitewater rafting trip, and I sign this release
on their behalf and on the behalf of the minor’s parents and/or legal
guardians. In addition, I give RELEASEES
permission to treat said minor in case of illness, injury, emergency or
accident. Should emergency medical
services become necessary for the undersigned participant or minor, the expenses
are the sole responsibility of the participant and not that of RELEASEES. Personal medical and travel insurance is
strongly advised for all participants.
RELEASEES reserve the right to accept or deny service to any
person. I hereby agree to follow all
rules, regulation, and instructions of RELEASEES while on this trip. I also certify that I and any minor on whose
behalf I am signing are physically and mentally capable of participating in
these activities. I hereby represent
that I have informed RELEASEES of any pertinent medical conditions that may
affect my or the minor’s participation in these rafting activities. I hereby agree that RELEASEES may use film or
photographic records of this rafting trip for its promotional and/or commercial
purposes. The venue of any dispute that
may arise out of this agreement or otherwise between the parties to which Rollinson Adventures or its agents is a party shall be the
town of
I
HAVE READ THIS DOCUMENT IN ITS ENTIRETY.
I understand that I am assuming all the risks inherent in this
whitewater rafting activity. I
understand that it is a release of any and all claims. I understand that this is the entire agreement
between the undersigned, Rollinson Adventures LLC.,
and all releasees as previously listed and that it
cannot be modified or changed in any way by the representations or statements
by Rollinson Adventures LLC., and all releasees or by the undersigned. I voluntarily sign my name as evidence of my
acceptance of all provisions in this release and I agree to be bound by them.
Name
of Participant:
_________________________________________________________________________________________
Signature:
_____________________________________________________ Date: ___________________________
(Parent or
legal guardian if under 18 years of age)
Please complete the following information for
yourself or the minor that you are signing for.
PLEASE PRINT CLEARLY – Thank You!!
Name of participant:
______________________________________________________________________________
Address:
________________________________________________________________________________________
City_____________________________________________ State _______ Zip _______________________________
Phone Number (Daytime):
(_____)_____________________(Evening): (____)___________________________
Email Address:
______________________________________
Date of Trip: ____ ____ ____ Were you the trip organizer?
Yes No
(Mo) (Day) (Year) If no, who is your Trip Organizer? __________________
NAME OF RIVER YOU ARE RAFTING
SOUTH FORK AMERICAN MIDDLE
FORK AMERICAN
In case of emergency contact:
Name: Phone number:
Do you have any medical
conditions or physical disabilities that we should be aware of? Yes
No
If yes, please explain:
Do you know how to swim? Yes
No