Waterfall Hike Registration Form

Guest Information

Name

First NameLast Name

Birthdate-Must be 13 or older-Parents must sign for their children.

Date

Gender

Email

example@example.com

Cell Number

Format: (000) 000-0000.

Are you a

Drivers Only- You must have insurance and a valid driving license. How may people are able to ride with you.

Emergency Information

Emergency Contact's Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Have you Hiked before?

Do you have any health limitations or physical injuries? Please indicate if you have any major health issues (ex high/low blood pressure, arthritis, asthma, diabetes, seizures, osteoporosis, etc.)

Women: Are you pregnant or is there any possibility of being pregnant? If Yes, please indicate your due date

Date

Are you bothered by scents (essential oils, incense, perfumes etc.)? If yes, please let us know the details.

Do you have any special dietary requirements? (eg: gluten-free (please specify if you are celiac), allergies, vegan etc…)

What dish or items would you like to bring for us all to share?

What inspired you to come to this hike?

AGREEMENT OF RELEASE AND WAIVER OF LIABILITY-Parents are accepting responsiblity for their teens.

I hereby agree to the following:

As I participate in activities offered by the hosts and special guests, I understand that the offerings of this event are not a substitute for medical attention, examination, diagnosis, or treatment.

I will receive hiking related information and instruction. I recognize that all hiking programs require physical exertion that may be strenuous and may cause physical injury and I am fully aware of the risks and hazards.

If at any time during the activities I feel discomfort or pain, I will inform and seek assistance from the hosts.

I may rest at any time during the hike. I will listen to my body and respect its limits on any given day.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any activity program. I represent and warrant that I am physically fit and I have no medical condition that would prevent my participation in this hike and all activities.

I recognize that it is my responsibility to notify my hosts of any serious illness or injury before every activity.

I accept that neither the instructors, driver, nor the hosting facility, are liable for any injury, or damages, to person or property, resulting from my participation in this hike.

I understand that I can either drive or give the driver gas money to offset the cost for travel.

Exclusion of Participation: In the unfortunate circumstance, if a guest conceals physical and/or health issues, is unfit, and/or causes disruptions that endanger the provision of the service and/or the health of other participants,facilitators, or equipment the guest can be excluded from the participation of the hike after an initial warning. If the situation arises, the contract will be terminated without further notice, already paid costs are non-refundable and incurring costs are to be paid by the guest.

I have read the above release and waiver of liability and fully understand it’s contents as well as the Refund/Cancellation Policies. I voluntarily agree to the terms and conditions stated above.

Signature

Date Signed

Date