Participant Waiver Form 2023 All fields and checkboxes must be filled out in order to submit the waiver. Date Name(Required) First Last Email(Required) Enter Email Confirm Email The undersigned voluntarily agrees to participate in activities and events provided by the Shared Adventures program in 2023. The undersigned recognizes that Shared Adventures has not undertaken any duty or responsibility for his or her safety and the undersigned agrees to assume the full responsibility for all risk of bodily injury, death, disability, and property damage as a result of participating in the events. The undersigned recognizes that these risks include: 1) The risk of injury from the equipment involved in the activity, including both misuse and malfunction. Equipment is including but not limited to: kayaks, paddles, safety harnesses, rock climbing walls & ropes, beach wheelchairs, transfer lifts, horseback riding equipment, bocce balls, cycles, bows & arrows, life preservers, gardening tools, table tennis paddles/balls/tables, bowling balls & shoes. 2) The risk of injury from environmental causes, including but not limited to: slippery trails or surfaces, falling debris, uneven road surfaces or sand, weather conditions. 3) The risk of injury from live animals involved in the activity, including but not limited to: horses, dogs, cows, petting zoo animals, wild marine animals. 4) The risk of injury from using hot glue guns, scissors, microwaves, toaster ovens, acrylic paints, dyes, clay and chemicals. 5) The risk of injury from field trips and any transportation that may be used. 6) The risk of being in close contact with other living beings who may carry communicable disease. I agree that this description of risks is not complete, and that unknown or unanticipated risks may result in property loss, injury, or death. I understand that the character of this program is to serve individuals who have physical or mental disabilities. I state that I am capable of participating in these activities. Therefore, I assume and accept full responsibility and assume the risk of and for any injury, death, loss of personal property, and/or expenses that may result from my involvement in this program, and I further agree to hold harmless the released party and associated facility with this activity. I agree to follow any additional rules set by the facility hosting this event. I agree to verbally disclose any relevant food allergies, medical conditions, and physical challenges to Shared Adventures. Acknowledge the risk by checking each box:(Required) I hereby acknowledge that I understand the risks involved in participating in the activities provided by Shared Adventures and willingly and voluntarily accept these risks. By my signature, I hereby surrender any right to seek reimbursement from Shared Adventures and its directors, officers, employees, volunteers and other agents for injury sustained and liability incurred during my participation in the activity. By my signature, I warrant that I am not relying on any oral representations, statements or inducement apart from the statements made on this form. Photo Release(Required) I agree on behalf of myself that any photos taken by Shared Adventures in connection with its activities may be used by Shared Adventures for future promotional marketing via print or electronic media of its programs. Consent to terms of waiver(Required) I hereby confirm that I have read, understand, and consent to the terms of this waiver agreement. By signing below, the parties confirm that they have read, understand, and consent to the terms of this waiver agreement.(Required)Parent or Guardian Signature is required (if the participant is under 18).CommentsThis field is for validation purposes and should be left unchanged.
