Liability Waiver

This waiver is to be completed by every adult (18 and older) in your party. The bottom section is to be completed by the parent or guardian of a minor child (ren)

PARTICIPANT AGREEMENT, RELEASE OF LIABILITY AND ASSUMPTION OF RISK

I desire to participate in boating activities on Lake George in the state of New York ("Activity") provided by Richard Jacobs, d/b/a Ridin' with Rich ("Business"). As lawful and sufficient consideration for being permitted by the business to participate in the activity, I agree to all the terms and conditions set forth in this release ("Agreement"). "Business" shall include, but not be limited to Richard Jacobs, Ridin' with Rich, Ridin' with Rich lg, and any affiliate or independent contractor associated with any of them.

My choice to participate is knowing, voluntary, and made for my personal enjoyment. I understand that participation in the activity involves inherent risks and dangers of accidents, bodily injury, death and severe personal economic losses. These may result not only from my actions, inactions or negligence, but also from the actions, inactions or negligence of others, or the conditions of facilities, equipment or vehicles. I understand that such risks cannot be eliminated without jeopardizing the essential qualities of the activity. Further, there may be other risks not known to me or reasonably foreseeable at this time. I understand and have considered the risks involved, and I voluntarily and freely choose to assume these risks. I also agree to wear a U.S. Coast Guard approved personal flotation device (aka life vest) while participating in this activity.

I fully and forever release and discharge the business and its respective owners, affiliates, directors, officers, shareholders, employees, agents, and insurers, and all others involved in the activity from any and all injuries (including death), losses, damage, claims (including negligence claims), demands, lawsuits, expenses, and any other liability of any kind, of or to me, my property, or any other person directly or indirectly arising out of or in connection with my participation in the activity, even due to willful or intentional act or omission, negligence, injudicious act, or other fault of the business.

I hereby irrevocably and unconditionally agree for myself, my personal representatives, my heirs, next-of-kin, successors, and assigns, as follows:

Please fill in your name: *

First Name Last Name

Signature *

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Date: *

Date

PARENT'S OR GUARDIAN'S RELEASE OF LIABILITY AND ASSUMPTION OF RISK

(Must be completed for each person under the age of 18 to pariticipate in activity)

1st Minor's name

First Name Last Name

2nd Minor's name

First Name Last Name

3rd Minor's name

First Name Last Name

4th Minor's name

First Name Last Name

5th Minor's name

First Name Last Name

6th Minor's name

First Name Last Name

Minor(s) being permitted to participate in activities and use of equipment, further agree to indemnify the business and also hold harmless the business from any and all claims which are brought by, or on behalf Minor(s) and which are any way connected with such use or pariticipation by Minor(s).

Parent or Guardian Name:

First Name Last Name

Parent or Guardian Signature:

Clear