Trailblazers: Blazing New Trails, An End of Year Trailblazers Celebration 

Participant Name   First Name*   Last Name*   Course Name    Please Select Trailblazers Nature Walk Trailblazers Retreat None *   

PLEASE READ THIS ENTIRE DOCUMENT (hereafter ”Document”) CAREFULLY BEFORE SIGNING. In consideration of the services of The Women’s Wilderness Institute, Inc. (DBA: Women’s Wilderness), and its officers, directors, employees, agents, representatives, volunteers, independent contractors and all other persons or entities associated with it (collectively referred to in this Document as “TWWI”),​ I agree as follows​:

The Women’s Wilderness Institute contracts with individuals or organizations that are independent contractors (not their employees or agents) to provide some of the services, and to conduct some of the activities you may engage in. Although TWWI has made efforts to locate responsible contractors, it does not supervise or control these contractors and is not legally liable or responsible for their conduct. In addition, activities may take place at facilities or on premises not owned by, or associated or affiliated with, TWWI. TWWI does not oversee, supervise, or take responsibility for any aspect or condition of these independent facilities or premises. I acknowledge that I may independently inspect and assess any of these contractors, facilities or premises, if I desire.

ACKNOWLEDGMENT AND ASSUMPTION OF RISKS
TWWI educational, instructional and/or adventure and recreation activities can occur inside or outside Colorado and can be conducted by TWWI staff or independent contractors. These activities can include, but may not be limited to: hiking and peak ascents; backpacking; rock climbing (both outdoors on natural rock and indoors on artificial walls); camping; orienteering; swimming; canoeing; fly-fishing; cross-country or back-country skiing; ice climbing; snowshoeing; mountain biking; high or low element ropes or challenge course activities; sports or interactive games or activities; volunteer community service projects and transportation with llamas, or to, from or during activities in vans, buses or other vehicles (collectively referred to in this Document as ”activities”). Activities may be scheduled or unscheduled, structured or unstructured, and include free time. ​I (or the minor participant) acknowledge that the inherent and other risks, hazards and dangers ​(collectively referred to in this Document as “risks”) ​of these activities can cause injury, damage, death or other loss to myself or others. The following describes some, but not all of those risks:

Risks present in an outdoor or wilderness environment. These risks include travel in high altitude, mountainous or wilderness terrain both on and off trail. Participants’ travel may be subject to lightning; strong winds; fast moving rivers or other water bodies; difficult stream and/or snowbridge crossings; falling rocks, ice, or objects; extremely hot (geothermal) or cold weather or water; snow and ice; avalanche dangers; falling or fallen timber; stinging, venomous or disease carrying animals or insects; poisonous plants; wild or domestic animals and other natural or man-made hazards. Hazards may not be marked or visible and weather is unpredictable year around.
Risks involved in decision making and conduct​, including the risk that a TWWI staff member, representative, volunteer, co-participant or contractor may misjudge a participant’s capabilities, health or physical condition, or misjudge some aspect of instruction, medical treatment, weather, terrain, water level, or, river and/or terrain route location.
Personal health and participation risks. The risk that a participant’s mental, physical or emotional condition (disclosed or undisclosed, known or unknown) combined with participation in these activities could result in injury, damage, death or other loss. Although TWWI personnel will review participants’ submitted health information, TWWI cannot anticipate or eliminate all risks or complications posed by a participant’s mental, physical or emotional condition.
Risks associated with travel. ​Travel can be on foot or by vehicle, skis, snowshoes, or other means and can be over rough and unpredictable terrain, highways or other roads, or via lakes and rivers, in snow, sleet, rain or other adverse weather conditions.
Risks connected with geographic location. ​Activities may take place in remote places, several hours or days from medical facilities, causing potential delays or difficulties in communication, transportation, evacuation and medical care. Although TWWI staff or contractors may have wireless communication devices (including cell or SAT phones) while conducting programs, use of these communication devices in outdoor, mountainous and/or wilderness terrain is unreliable and inconsistent.
Equipment risks. The risk that equipment used in an activity may be misused, or may break, fail or malfunction. TWWI requires helmets or other safety gear for some activities. Safety gear may prevent or lessen injuries in some instances; however, use of safety gear is not a guarantee of safety, and injury can occur even with the use of this gear.
Cooking and camping risks. Risks include gas explosion, scalding or other burns associated with cooking over a gas stove or open fire, and water contamination in natural water sources. Water may be contaminated and must be disinfected or boiled before use.
Volunteer community service risks​. Participating in volunteer service projects can include risks associated with activities such as building, digging, lifting, painting, construction and clean-up projects. Projects may include the use of tools and equipment (i.e. drills, saws, power tools) that can cause injury resulting from use, misuse or malfunction.
Risks associated with free time. Participants may have free time before, during and after the start of a course and at various other times. Unsupervised time may include free time, or time where participant is stationary, alone and possibly overnight in the field for up to 24 hours (solos).
Risks regarding conduct. ​The potential that participant, or other participants or third parties (e.g. driver, rescue squad, hospital) may act carelessly or recklessly; or that a participant may react adversely or suffer emotional trauma arising out of her participation or for any other reason.
Other risks ​that are generally associated with educational, instructional and/or recreation and adventure activities.

These and other risks may result in participants: falling partway or falling to the ground; being struck; colliding with or impacting objects or people; experiencing vehicle or boat collision, capsize or rollover; reacting to high altitudes, weather conditions or increased exertion; becoming lost or disoriented, suffering gastro-intestinal complications or allergic reactions or experiencing other problems. These and other circumstances may cause hypothermia, hyperthermia (heat-related illness), heat exhaustion, dehydration, frostbite, drowning, high altitude sickness, heart or lung complications, broken bones, paralysis, mental or emotional trauma, concussions, sunburn or other burns or other injury, damage, death or loss.

I (or the minor participant) acknowledge and agree:

•  to read, understand and abide by the terms of this Document, the Application, and other TWWI forms, and to obey all TWWI rules and policies;
• TWWI staff are and have been available should I (or the minor participant) have further questions about these activities or the associated risks;
• if I (or the minor participant) have any mental, physical or emotional condition/s or limitation/s which might affect my (or the minor participant’s) ability to participate I (or the minor participant) agree to disclose those to TWWI, and represent that I (or the minor participant) is fully capable of participating in these activities without causing harm to myself (or themselves) or others;
• that TWWI cannot assure my safety or eliminate any of these risks, and that during both supervised and unsupervised activities, all participants share in the responsibility for their own well-being;
• that consumption or use of illegal drugs, marijuana, and/or alcohol is not permitted on TWWI courses, and that the use and/or possession of marijuana on federal land is illegal. If I/participants bring and/or consume alcohol, marijuana or any illegal drugs on course, I/the participant may be dismissed from the program.
• I (or the minor participant) have read the COVID-19 Policies and Procedures and understand that these constitute TWWI's best efforts to avoid the exposure to and/or spread of COVID-19 during TWWI courses. I agree that I (or the minor participant) will abide by these policies and procedures. I accept the risk, on my own behalf or on behalf of the minor participant, that despite TWWI's implementation of and conduct under the COVID-19 Policies and Procedures, there remains a risk of exposure to COVID-19, and I release TWWI from any associated liability.
• I (or the minor participant) am voluntarily participating with knowledge of the risks. Therefore, I (or the minor participant) assume and accept full responsibility for me (or the minor participant) , for the inherent and other risks (both known and unknown) of these activities and for any injury, damage, death or other loss suffered by me (or the minor participant), resulting from those risks and/or resulting from my (or the minor participant’s) negligence or other misconduct.

RELEASE AND INDEMNITY AGREEMENT
Please read carefully. This Release and Indemnity Agreement contains a surrender of certain legal rights. ​Certain federal land agencies may restrict service providers from seeking releases of liability for negligence, for injuries or other losses occurring while operating under permit on some federal lands. Therefore, except to the extent a court determines these federal restrictions apply to TWWI as a matter of law​, I (or the minor participant) agree as follows:

1. ​to release and not to sue TWWI with respect to any and all claims, liabilities, suits, or expenses (including attorneys’ fees and costs) (hereafter collectively ”claim” or “claim/s”), in any way connected with my enrollment or participation in these activities, or use of TWWI equipment, facilities or premises. ​I(or the minor participant) understand that in signing this Document, I (or the minor participant),and anyone acting on my(or the minor participant) behalf, surrender all rights to make a claim against TWWI, for any injury, damage, death or other loss suffered by me (or the minor participant)​;
2. ​to defend, indemnify ​('indemnify' meaning protect by reimbursement or payment) ​and hold harmless​ ​TWWI​ with respect to any and all claim/s:

(a) brought by or on behalf of me (or the minor dependent) or a family member for any injury, damage, death or other loss in any way connected with my (or the minor participant’s) enrollment or participation in these activities, or use of any equipment, facilities or premises; and/or,
(b) brought by a co-participant or any other person, for any injury, damage, death or other loss to the extent caused by my (or the minor participant’s) conduct in the course of participating in these activities or using any equipment, facilities or premises.

1. This Release and Indemnity Agreement includes claim/s resulting from TWWI’s negligence (but not its gross negligence or willful, wanton or criminal misconduct), and includes claim/s for personal injury or wrongful death (including claim/s related to emergency or medical response, assessment or treatment), property damage, breach or contract or any other claim.

EMERGENCY MEDICAL RELEASE
I (or the minor participant) authorize TWWI staff, representatives, volunteers or contractors to obtain or provide medical care for me (or the minor participant), to transport me (or the minor participant) to a medical facility and to provide treatment they consider necessary for my (or the minor participant’s) health. In case of a medical emergency, I hereby give permission to the physician selected by an authorized representative of Women's Wilderness to secure proper medical treatment for I (or the minor participant), including, but not limited to, injections, anesthesia, surgery, and hospitalization. I (or the minor participant) agree to pay all costs associated with medical care and transportation and further agree to the release (to or by TWWI) of any medical records necessary for treatment, referral, billing or insurance purposes.

I (or the minor participant) have reviewed the medical form and certify that all information is accurate and complete. I have read and understand the above paragraph, and agree to indemnify and hold TWWI harmless if all relevant information is not disclosed. I understand that I am responsible for any medical costs that are incurred as a result of my (or the minor participant’s) participation on course.

OTHER PROVISIONS
I (or the minor participant) agree that Colorado law (without regard to its conflict of laws rules) governs this Document, any dispute I (or the minor participant) have with TWWI, and all other aspects of my relationship with TWWI, and that any mediation, suit, or other proceeding must be filed or entered into only in Boulder County, Colorado. I (or the minor participant) agree to attempt to settle any dispute (that cannot be settled by discussion) through mediation before a mutually acceptable Colorado mediator. I (or the minor participant) authorize TWWI and/or parties or entities designated by TWWI, to take my (or the minor participant’s) photo and to use it for sale or reproduction in any manner TWWI desires, for advertising or other use, without compensation to me (or the minor participant). All negatives, prints and/or electronic photographs are the property of TWWI. All TWWI trips begin and end at the trailhead, and I (or the minor participant) understand that I (or the minor participant) am solely responsible for my transportation to and from the trailhead. TWWI reserves the right to remove any participant from the program that staff believes, in their discretion, presents a safety concern or medical risk, is disruptive, or otherwise conducts herself in a manner detrimental to the program. If I (or the minor participant) am dismissed or depart for any reason, I (or the minor participant) understand that I (or the minor participant) am responsible for any and all costs of early departure whether for medical reasons, dismissal or otherwise. ​This Document is intended to be interpreted and enforced to the fullest extent allowed by law. If any portion of this Document is deemed unlawful or unenforceable it shall not affect the enforceability of the remaining provisions and those remaining provisions shall continue in full force and effect.

I understand​: ​I (or the minor participant) understand that TWWI courses are physically and mentally strenuous experiences that take place in a remote wilderness area, far from conventional medical facilities. The information in my registration form is a complete and accurate statement of my (or the minor participant) past and present medical condition, and I (or the minor participant) have included all physical and psychological factors that may affect my participation in a Women’s Wilderness Institute course. I (or the minor participant) realize that failure to disclose such information could result in serious harm to myself and/or fellow participants. I (or the minor participant) agree to indemnify and hold TWWI harmless if all relevant information is not disclosed. I (or the minor participant) agree to notify TWWI should there be any change in my health status prior to my course start. I (or the minor participant) understand that due to the nature of a wilderness experience, there may be times when I (or the minor participant) am physically tired and/or uncomfortable. That I (or the minor participant) am not permitted to bring or use alcohol, recreational drugs, or tobacco products while on the course. That violence or the threat of violence towards others or myself (or the minor participant) is not permitted, and may mean being removed from the course. That due to the remote nature of the course, it is extremely difficult and disruptive to the course for someone to leave early. I (or the minor participant) understand that by participating I (or the minor participant) am making a commitment to stay for the duration of the course, except in the case of an emergency. That I (or the minor participant) will be expected to practice environmental stewardship and the principles of the“Leave No Trace” ethic, which will be explained to me in detail by my (or the minor participant’s) instructors. That I (or the minor participant) will be required to follow all safety policies while on course.

I agree​: I have carefully read and understand this Document and voluntarily sign this Document and acknowledge that by signing it I have given up substantial rights and understand that it shall be effective and binding upon me, my minor children, spouse and other family members, next of kin and my heirs, executors, representatives, subrogors and estate.

Signature*   Date   First Name*   Last Name*   

FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE

If the participant is under 18 years of age (or if the participant is a resident of Alabama and under 19 years of age) (or if the participant is a resident of Mississippi and under 21 years of age), at least one parent or guardian must also sign.

This is to certify that I, as parent/guardian with legal responsibility for this Participant, do consent and agree to her release as provided above of TWWI, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless TWWI from any and all liability incidents to my minor child’s involvement or participation in the program as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF TWWI, to the fullest extent provided by law.


     Parent Signature   Date   Parent First Name   Parent Last Name