Rafting Sign up Form
Fill out the form carefully for registration
Participant Name
First Name
Last Name
Birth Date
Please select a month
January
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Month
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Day
Please select a year
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Year
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Additional Comments
Do you understand that we are not a commercial company and that this is an exciting opportunity where like minded individuals come together to share duties (like inflate rafts, paddle down the river and load rafts back on car) Also and fun!!
Yes
Do you have any allergies, injuries or medical conditions that we should know about?
I, the participant, agree with the following statements:
I am physically able to take part in the activity
I know whitewater rafting is an inherently dangerous activity and there is risk of injury or death. I understand this risk and I hereby release Explore with the Eggerts, Tammy and Gary Eggert, The Eggers family and any of its volunteers, and/or affiliated organizations from all actions, claims, or demands that I, my assignee's, heirs, distributes, guardians, and legal representatives nor have, or may hereafter have, for injury, death or damage resulting from my participation in the above described activities. I AM AWARE THAT THE ABOVE DESCRIBED ACTIVITIES ARE HAZARDOUS ACTIVITIES, THAT I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF DANGER INVOLVED, AND HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJOURY OR DEATH. BY REGISTERING AND CLICKING THE SUBMIT BUTTON below, I DECLARE THAT I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND CONTRACT BETWEEN MYSELF AND EXPLORE WITH THE EGGERTS (TAMMY EGGERT), AND/OR ITS VOLUNTEERS AND AFFILIATED ORGANIZATIONS, AND AM ENTERING THIS ACTIVITY AT Y OWN FREE WILL
I will respect our river guides requests while on the river and event organizers while in camp.
Enter todays date
Signature (If under 18, must have parent/guardian sign)
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