BlazingPaddlesWaiverAndRelease

SYNERGY OUTDOOR ADVENTURE RESOURCES WAIVER, RELEASE FROM LIABILITY AND IMAGE RELEASE PLEASE READ CAREFULLY BEFORE SIGNING

I acknowledge that sporting events and activities of Synergy Outdoor Adventure Resources, Inc. (hereinafter SOAR) test physical and mental limits and carry the potential for death, serious injury (including but not limited to drowning, trauma, disease, exposure, heart attack, and various injuries through collision, capsize, exertion and other means/events) or property loss. With full knowledge of the activities involved, I HEREBY ASSUME THE RISKS OF PARTICIPATING IN SOAR EVENTS AND ACTIVITIES. (THIS RELEASE SHALL REMAIN IN EFFECT UNTIL A WITHDRAWAL IS DELIVERED TO SOAR BY BOTH CERTIFIED MAIL, RETURN RECEIPT REQUESTED, AND BY EMAIL TO WillMurphy@SOARteam.com) The undersigned acknowledges that a Waiver and Release in this form must be in effect whenever they participate in a SOAR event or activity and this requirement cannot be waived and their participation shall be deemed agreement to the terms set forth herein.

In consideration of permission to participate in SOAR activities (including but not limited to dragon boat training and racing and related activities) and other adequate and sufficient consideration, I hereby take the following action for myself, my executors, administrators, heirs, next of kin, successors and assigns: a) I WAIVE, RELEASE, AND DISCHARGE from any and all claims or liabilities for death or personal injury or damages of any kind, which arise out of or related to my participation in, or my traveling to and from any SOAR event, THE FOLLOWING PERSONS OR ENTITIES: Synergy Outdoor Adventure Resources, Inc. (SOAR); the Event Director; the Event Owner; Sponsors; Participants, Hosts/Land Owners, Coaches; Trainers; Providers of equipment or supplies; and the officers, directors, employees, volunteers, representatives, and agents of any of the above (collectively. the SOAR Entities): b) I AGREE NOT TO SUE any of the SOAR entities for any of the claims or liabilities I have waived, released or discharged herein: and c)I INDEMNIFY AND HOLD HARMLESS the SOAR entities from any claims made or liabilities assessed against them or any of them as a result of my actions except those resulting from the willful acts or gross negligence of any such SOAR entity. ==> I hereby authorize any licensed physician, emergency medical technician, hospital or other medical facility. or other personnel to treat me for the purpose of attempting to treat or relieve any injuries received by me arising out of or relating to the SOAR event. I authorize the performance of any procedures deemed medically advisable in attempting to treat or relieve any such injuries. I consent to the administration of anesthesia as deemed advisable. I understand that there is a possibility of complications and unforeseen consequences in any medical treatment, and I assume any such risk. ==> I also grant permission for the use of my name and or likeness related to my participation in any event conducted by SOAR. I also grant the use of my voice and any and all recorded and or filmed/video/photographed footage of me, and further waive all rights to any compensation, as a result of my name or likeness being used in any way.

Event*

Dragonboat PracticeSynergy Series Fall Edition - 9/16/2023Synergy Series Finale - 12/9/2023Other

PRINT NAME*

E MAIL ADDRESS*

example@example.com

Phone Number

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SIGNATURE*

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DATE*

Date

Emergency Contact Name*

Emergency Contact Phone Number*

Required Selection*

I AM OVER THE AGE OF EIGHTEEN (18) YEARS. I HAVE READ. UNDERSTOOD AND AGREE TO THE FOREGOING.I AM UNDER THE AGE OF EIGHTEEN (18) YEARS AND I HAVE READ THIS DOCUMENT. MY PARENT/GUARDIAN HAS ALSO READ AND COMPLETED THE SECTION BELOW.

(If applicant is under 18 years of age. a parent or guardian must execute, in addition to the foregoing Waiver and Release. the following, for and on behalf of the minor, as well as the Addendum for Use in Florida. I, {parentguardianName}, the parent and natural guardian or legal guardian of (hereinafter "the minor") hereby executes the foregoing Waiver and Release for and on behalf of the minor. I hereby bind myself, the minor and all other assigns to the terms of the Waiver and Release and authorization for medical treatment. I represent that I have legal capacity and authority to act for and on behalf of the minor named herein, and I agree to indemnify and hold harmless the SOAR Entities mentioned above for any claims or liabilities assessed against them as a result of any insufficiency of my legal capacity or authority to act for and on behalf of the minor in the execution of the Waiver and Release and authorization. I agree to the terms of the Addendum for Usein Florida

PARENT/GUARDIAN NAME

First NameLast Name

NAME OF MINOR PARTICIPANT

First NameLast Name

PARENT/GUARDIAN SIGNATURE

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DATE

Date

RELATIONSHIP TO MINOR

ADDENDUM FOR USE IN FLORIDA NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. You are agreeing that even if Synergy Outdoor Adventure Resources, Inc. (SOAR); the Event Director; the Event Owner; Sponsors; Participants, Hosts/Land Owners, Coaches; Trainers; Providers of Equipment or Supplies; and the officers, directors, employees, volunteers, representatives, and agents of any of the above (collectively, the SOAR Entities) uses reasonable care in providing this activity, there isa chance your child may be seriously injured or killed by participating in this activity because there are certain dangers inherent in the activity which cannot be avoided or eliminated. By signing this form you are giving up your child's right and your right to recover from the SOAR Entities or any of them in a lawsuit for any personal injury, including death, to your child or any property damage including any that results from the risks that are a natural part of the activity. You have the right to refuse to sign this form, and the SOAR Entities have the right to refuse to let your child participate if you do not sign this form.

Printed Name of Minor Participant

Signature of Natural Guardian If Participant is a Minor, by my signature, I release all claims that both they and I have.

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Name of Guardian

Date