Friends of the Rappahannock -General Waiver

Friends of the Rappahannock -

General Waiver

IMPORTANT: THIS IS A LEGAL DOCUMENT

Please read and understand this document before signing. If you have any questions please ask us or consult an attorney.

Type of Activity*

Please select that the type of volunteer activity you will be participating in.

Select

Volunteer/Participant Activity*

Please enter the name of the Event or Activity you are participating in.

Indemnity, Release of Liability and Acknowledgment of Assumption of Risk*

I understand and agree that Friends of the Rappahannock (“FOR”) Volunteer/Participant activities are entirely voluntary on my part and may involve potentially strenuous and hazardous activities and there are risks of accidents arising out of these activities. I have no expectation of compensation for these activities. I acknowledge that I currently have no known mental or physical condition that would impair my capability for full participation as intended or expected. I expressly assume all risks of injury, bodily harm or property damage arising out of my activities with FOR.

I further acknowledge that I am responsible for my own insurance coverage and FOR has no liability or responsibility to me for any medical, health or other benefits or compensation.

I release and forever discharge FOR, its successors and assigns, employees, officers, directors and agents, and any sponsoring organizations from any and all claims, liabilities and demands of any kind or nature, in law or equity, arising out of my activities with FOR, including any claims for bodily injury, death, illness or property damage occurring while engaged in my activities with FOR, even if caused by the negligence or reckless conduct of a FOR employee or Volunteer/Participant. I further agree to indemnify and hold harmless FOR, its successors and assigns, employees, officers, directors and agents, and any sponsoring organizations in connection with any of the foregoing.

In case of emergency or accident, I give permission for any first aid treatment or other medical services rendered on my behalf, and release FOR from any and all liability in connection with any medical services. I agree to be the responsible party for all medical expenses incurred on my behalf.

I agree to the above conditions.

Do you have a medical condition that would prevent you from fully participating in this event?*

YES, I would like to speak to a staff person about how I might support this event within my capacity.

NO.

Is this an On-Water program?*

All of FOR's programs are on small rapids (Class II-I) or Flatwater. If a program will be on water with a higher rapid class, you will be notified.

This program is NOT on water.

This program is ON WATER (Class I-II Rapids or flatwater)

Essential Eligibility Criteria*

I understand that to SAFELY participate in this on water activity, I (or the participant) must meet ALL Essential Eligibility Criteria listed below.

Manage personal mobility independently or with a reasonable amount of assistance.
Follow instructions and effectively communicate independently or with assistance of a companion
Independently turn from face-down to face-up and remain floating face up while wearing a properly fitted life jacket
Get in/out or on/off of a paddle craft independently or with a reasonable amount of assistance
Independently get out and from under a capsized paddlecraft
FOR's watercraft has a weight limit for participants to weigh under 275 lbs.

FOR staff reserves the right to not allow a participant to continue program, should they not meet these criteria.

YES, I meet all Essential Eligibility Criteria.

NO, I do not meet criteria.

Boat Weight Limits*

Due to our kayak/canoe weight safety limits it is helpful for us to know your general weight.

I weigh ABOVE 275 lbs.

I weigh BELOW 220 lbs

I weigh BELOW 275 lbs

Photo Release*

I agree to grant FOR the right and unrestricted permission concerning any photographs that FOR has taken or may take of me or in which I may be included with others, to use, reuse, publish, and republish the photographs in whole or in part, individually or in connection with other material, in any and all media now or hereafter known, including the internet, and for any purpose whatsoever, without restriction as to alteration; and to use my name in connection with any use if FOR so chooses. I grant FOR all right, title and interest in any photographs, images, video or other media recordings taken by me or of me or my likeness or voice in connection with my activities with FOR. I release and discharge FOR from any and all claims and demands that may arise out of or in connection with the use of the photographs, including without limitation any and all claims for libel or violation of any right of publicity or privacy.

I understand & agree

I understand & DO NOT agree

Individual/Guardian Agreement*

I am of legal age. I have read this form and understand and acknowledge the risks and liability. I understand that by signing this form, I am giving up legal rights and remedies.

I am the parent or legal guardian of the Volunteer/Participant. I have read this form and understand and acknowledge the risks and liability. I understand that by signing this form, I am giving up legal rights and remedies.

Electronic Signature Agreement*

I agree that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.

Participant Full Name*

Parent/Guardian Full Name

(Only required if participant in under 18 years old)

Participant Date of Birth*

Home Street Address*

City*

State*

Virginia

Zip Code*

Participant Phone Number*

(If participant is under 18 years old, please input parent/guardian phone number)

Phone

Participant Email*

(If participant is under 18 years old, please input parent/guardian phone number)

Add Second Participant*

Please only complete multi-person waiver with individuals living in your household.

No, I'm done with the waiver.

Yes, add another household member.

Participant 2 Full Name*

Participant 2 Date of Birth*

Participant 2 Agreement*

I am of legal age. I have read this form and understand and acknowledge the risks and liability. I understand that by signing this form, I am giving up legal rights and remedies.

Participant 2 Photo Release*

I agree and understand

I DO NOT agree and understand.

Participant 2 Essential Eligibility Criteria*

I understand that to SAFELY participate in this on water activity, I (or the participant) must meet ALL Essential Eligibility Criteria listed below.

Manage personal mobility independently or with a reasonable amount of assistance.
Follow instructions and effectively communicate independently or with assistance of a companion
Independently turn from face-down to face-up and remain floating face up while wearing a properly fitted life jacket
Get in/out or on/off of a paddle craft independently or with a reasonable amount of assistance
Independently get out from under a capsized paddlecraft
FOR's watercraft has a weight limit for participants to weigh under 220 lbs.

FOR staff reserves the right to not allow a participant to continue program, should they not meet these criteria.

YES, I meet this criteria

No, I do not meet this criteria

Participant 2 Electronic Signature Agreement*

I agree that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.

Add Third Participant*

Please only complete multi-person waiver with individuals living in your household.

No, I'm done with the waiver.

Yes, add another family member.

Participant 3 Full Name*

Participant 3 Date of Birth*

Participant 3 Agreement*

I am of legal age. I have read this form and understand and acknowledge the risks and liability. I understand that by signing this form, I am giving up legal rights and remedies.

Participant 3 Photo Release*

Yes, I agree and understand

No, I do not agree and understand.

Participant 3 Essential Eligibility Criteria*

I understand that to SAFELY participate in this on water activity, I (or the participant) must meet ALL Essential Eligibility Criteria listed below.

Manage personal mobility independently or with a reasonable amount of assistance.
Follow instructions and effectively communicate independently or with assistance of a companion
Independently turn from face-down to face-up and remain floating face up while wearing a properly fitted life jacket
Get in/out or on/off of a paddle craft independently or with a reasonable amount of assistance
Independently get out from under a capsized paddlecraft
FOR's watercraft has a weight limit for participants to weigh under 220 lbs.

FOR staff reserves the right to not allow a participant to continue program, should they not meet these criteria.

Yes, I meet these criteria.

No, I do not meet these criteria.

Participant 3 Electronic Signature Agreement*

I agree that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.

Emergency Contact Full Name*

This should be someone who is not in attendance with you.

Emergency Contact - Relationship*

Select

Emergency Contact - Relationship "OTHER"*

Emergency Contact Phone Number*

Phone

Add me to your Email Updates

I would like to be added to the bi-weekly Friends of the Rappahannock's Email updates

Send me a copy of my responses

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