Release Of Liability Waiver

Check One*

CLUB MEMBERCLUB GUESTMINOR Member/Guest (under 18yrs old)

Is Minor a Guest or Annual Participant?*

GUESTANNUAL PADDLING ATTENDEE

Participating minor children must have their own individual waiver completed and signed by a parent/legal guardian and shall be accompanied by that parent/legal guardian or their designee at any event.

Guest Minor Participation Date.*

Date

Guest Minor- What event is minor participating in.*

ONLY IF MINOR IS NOT A REGULAR ATTENDEE

Guest Participation Date*

Date

What is the event you are Participating in?*

Event Name

Name of Parent/Legal Guardian/Designee accompanying the minor.*

Participant Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Minor Date of Birth*

Date

Name of Parent/Legal Guardian*

First NameLast Name

Relationship to Participant*

Email*

example@example.com

Phone Number*

Area CodePhone Number

Email*

example@example.com

Emergency Contact:*

First NameLast Name

Emergency Contact Phone:*

Area CodePhone Number

Poudre Paddlers Safety Requirements

Poudre Paddlers offers trips and outings arranged by volunteer trip coordinators. These activities facilitate interaction among paddlers of similar skill levels. All members are required to annually sign the club’s “Paddlesport Risk Management LLC” waiver before participating in any Poudre Paddlers event. Guest are also required to sign a waiver before joining an event. Participating minor children must have their own individual waiver completed and signed by a parent and shall be accompanied by that parent or their designee at any event.

All members who participate in the trips will be responsible for their own conduct, safety and capabilities. To maximize boaters’ understanding and safety, participants are required to read and abide by the following Poudre Paddlers safety requirements:

• Trip coordinators must hold an onshore safety talk before getting on the water. Coordinators shall use the club’s “Pre Trip Safety List”. All participants shall attend the meeting.

• The use of alcohol or mind altering drugs is prohibited during any event or shuttle. Anyone suspected of having impaired behavior is prohibited from participation. (An event is over when the person is off the water for the day and not involved in shuttling).

• PFDs are required to be worn at all times while on the water. PFDs must be US Coast Guard approved. They must be worn and fastened the way the manufacturer designed them to be. They shall also be in good condition; no rips, tears or repairs. Type I, III, or V are required on moving water.

• Participants must wear adequate cold-water protection in case of a swim. The water can be extremely COLD especially in the early season. Dry suits, wet suits, or equivalent protection during cold-water swims is required. If the trip coordinator deems that you are not wearing adequate cold-water protection they may ask you to not participate. Remember, dress for the swim not the weather.

• Participants shall abide by the Trip Coordinators decision on who can participate in a particular event based on both skill level and appropriate equipment and the Trip Coordinator may decide that a participant shall leave the water.

Class II, and above rated river.

• Whitewater Helmets are required to be worn at all times while on the water. Bicycle helmets or any non-whitewater helmet are not allowed.

• Hard Shell Kayaks and open canoes must have adequate flotation. Kayaks are required to have stern flotation bags (small play boats are exempt). Canoes must have both bow and stern bags. Tandem canoes must have bow, middle, and stern bags. Note: Camping gear that fills bow, middle or stern may replace flotation bags.

• Proper footwear is required. In case of a swim, footwear must be tight enough to avoid slipping off. Closed-toe river footwear is recommended.

• Each participant shall carry an Emergency Whistle rated for water use.

• At least one throw bag is required within the group for Class II and up. Multi-day trips may have
additional safety and equipment requirements.

In consideration of being allowed to participate in any way in this sports activity, related events and activities, the undersigned appreciates and acknowledges:

1) I understand the risk of injury or illness from the activities involved in this sport is significant, including the potential for permanent paralysis and death; and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury or illness does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM ALL NEGLIGENCE OF THE RELEASEES or others and assume full responsibility for my participation.

2) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the trip coordinator immediately. I will not consume alcoholic beverages or mind altering drugs and do not have any medical conditions or take medications that could affect my abilty to follow directions or be adversly affected by vigorous physical activity.

3) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY WAIVE, RELEASE, INDEMNIFY AND HOLD HARMLESS PADDLESPORT RISK MANAGEMENT, LLC; POUDRE PADDLERS; their officers & directors, officials, agents,and/or employees, municipalities, government agencies, parks and recreation departments; other participants, sponsoring agencies, commissions, sponsors, advertisers, volunteers, coaches, steerers, and, if applicable, owners and lessors of premises and equipment used to conduct club activities/ special club only events (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

4) I also acknowledge that photographs and video may be taken of me in my participation in, and attendance during this club activity, and hereby freely agree to allow without restriction all uses of such photos and videos in the reporting of club activities, special race, and/or in the promotion of such, its location, other sporting events, sport in general, and/or related purposes.

By signing below I acknowledge that I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY.

By signing this waiver, I also acknowledge that I have read, comprehend, and will abide by the Poudre Paddlers Safety Requirements.

Signature*

PARENT/LEGAL GUARDIAN STATEMENT.

This is to certify that I, as parent/legal guardian with legal responsibility for this PARTICIPANT, I have read the waiver of liability to the minor participant and confirm they fully understand its contents and therefore, I do consent and agree to his/her Waiver, Release and Indemnification, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement in the paddling program as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Signature of Parent/Legal Guardian*

Date*

DateHourMinutesAM/PM Option

Waiver, Release & Indemnity