Release and Waiver of Liability

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WAIVER OF LIABILITY* This field is required.ACKNOWLEDGMENT AND ASSUMPTION OF RISKS & RELEASE AGREEMENT FOR VOLUNTEER LED ACTIVITIES PLEASE READ THIS ENTIRE DOCUMENT (hereafter 'Document') CAREFULLY BEFORE SIGNING. All participants must sign this Document. For participants under 18 yrs. of age (hereafter sometimes ‘minor’ or ‘child’), parent/s or legal guardian/s (hereafter collectively ‘parent/s’) must also sign. In consideration of the services of the Great Pond Mountain Conservation Trust, a charitable, not-for-profit corporation, organized and existing under the laws of Maine, including all officers, directors, employees, representatives, agents, independent contractors, volunteers (including leaders and co-leaders), members and all other persons or entities associated with it (collectively referred to in this Document as 'GPMCT'), I (participant and parent/s of a minor participant) acknowledge and agree as follows: GPMCT volunteer-led educational and/or adventure activities may include, but are not limited to hiking, camping, biking, skiing, maintenance of trails and facilities, canoeing, kayaking,, use of GPMCT huts or other facilities and transportation or travel to and from activities (referred to in this Document as 'activities' or 'these activities'). The leaders of these activities are volunteers. They are not paid professional guides or leaders. In all activities, all participants share in the responsibility for their own safety and the safety of the group. Participants (and parents of minors) take responsibility for having appropriate skills, physical conditioning, equipment and supplies for these activities. These activities include inherent and other risks, hazards and dangers (referred to in this Document as ‘risks’) that can cause or lead to injury, property damage, illness, mental or emotional trauma, paralysis, disability or death to participant or others. Some, but not all of these risks include: hazardous and unpredictable ground, water or weather conditions; misjudgments made by leaders, co-leaders, participants or others; travel in remote areas that can cause potential delays or difficulties with transportation, evacuation and medical care; equipment that can fail or malfunction; infectious disease, including but not limited to COVID-19; the potential that the participant or others (e.g. co-participant, driver, medical and rescue personnel) may act carelessly or recklessly. I understand that GPMCT cannot assure participant's safety or eliminate any of these risks. Participant is voluntarily participating with knowledge of the risks. Therefore, participant (and parent/s of minors) assume and accept full responsibility for the inherent and other risks (both known and unknown) of these activities, and for any injury, damage, death or other loss suffered by participant, resulting from those risks, and/or resulting from participant’s negligence or other misconduct. I (adult participant, and/or Parent/s for themselves and for and on behalf of their participating minor child) agree to release and not to sue GPMCT (as GPMCT is defined above) in regard to any and all claims, liabilities, suits, or expenses (including reasonable costs and attorneys’ fees) (hereafter collectively ‘claim’ or 'claim/s'), including claim/s resulting from GPMCT’s negligence (but not its gross negligence or intentional or reckless misconduct), for any injury, damage, death or other loss to me or my child, in any way connected with my or my child’s enrollment or participation in these activities, or my use of GPMCT equipment, facilities or premises. I understand I agree here to waive all claim/s I or my child may have against GPMCT, and agree that neither I, my child, or anyone acting on my or my child’s behalf, will make a claim against GPMCT. I (participant and parent/s of a minor participant) agree that the substantive laws of Maine govern this Document and all other aspects of my relationship with GPMCT, and that any mediation, suit, or other proceeding must be filed or entered into only in Maine. This Document is intended to be interpreted and enforced to the fullest extent allowed by law. Any portion of this Document deemed unlawful or unenforceable shall not affect the remaining provisions, and those remaining provisions shall continue in full force and effect.
I HAVE CAREFULLY READ, UNDERSTAND AND AGREE
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Photo Release* This field is required.I hereby authorize the Great Pond Mountain Conservation Trust (GPMCT) and/or parties designated by the GPMCT (including periodicals, other printed matter, or electronic media, and their editors) to use my photograph for sale to or reproduction in any medium the GPMCT or its designees see fit for the purposes of advertising, display, exhibition, or editorial use.
I authorize GPMCT to use my photograph.
I do not authorize GPMCT to use my photograph.
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Name* This field is required.
First Name
Last Name
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Email* This field is required.
example@example.com
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AGE* This field is required.
18 OR OLDER
UNDER 18
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Name of Parent / Guardian for Waiver
First Name
Last Name
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Emergency ContactPlease complete if an emergency contact hasn't already been provided.
NAME
PHONE
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Volunteer or Event DateDate of volunteer day or event.
Date
Year
Month
Day
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Signature* This field is required.PARTICIPANT AND PARENT/S OF A MINOR PARTICIPANT AGREE: I HAVE CAREFULLY READ, UNDERSTAND AND VOLUNTARILY SIGN THIS DOCUMENT AND ACKNOWLEDGE THAT IT SHALL BE EFFECTIVE AND BINDING UPON ME, MY MINOR CHILDREN AND OTHER FAMILY MEMBERS, AND MY HEIRS, EXECUTORS, REPRESENTATIVES AND ESTATE. Parent/s must sign, both in their capacity as a participant, and as Parent/s of any minor child identified below.
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