Paddle Event Registration - The Inkpaduta Canoe Trail (MAY 24)

Paddle Event Registration - The Inkpaduta Canoe Trail (MAY 24TH, WANATA to THE PRAIRIE HERITAGE CENTER)

RELEASE OF LIABILITY WAIVER ACKNOWLEDGEMENT
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Where Are You Coming From?*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
YesNo (Anyone under the age of 18 must be accompanied by a legal guardian as well as have a signed waiver prior to the paddle)
I'm a first time river paddlerBeginnerIntermediateAdvancedI'm not sure
NoYes, I will likely need or require assistance
NoYes, I will likely need or require assistance
Yes, I can manage my own safety and that of my groups safetyNo, I am not able to manage my own safety on the riverI am not sure
If there is anything you'd like to share with us that we should be aware of regarding the upcoming paddle or questions you have, let us know! If yes, please write here below or email info@inkpadutacanoetrail.org for questions.
In consideration of being allowed to participate in any way in the Iowa Department of Natural Resources and Shelby County Conservation Board water trail event, and related events and activities, the undersigned agrees to the following: 1. Prior to participating, I will inspect the facilities and equipment to be used, and if I believe anything is unsafe, I will immediately advise a coach, instructor, supervisor, or other event organizer of such condition(s) and refuse to participate. 2. I acknowledge and fully understand that I will be engaging in activities that involve risk of damage to personal property or serious injury, including permanent disability and death, and severe social and economic losses which might result not only from my own actions, inactions or negligence, but the actions, inactions or negligence of others, the rules of play, the condition of the premises, or of any equipment used. Further, there may be other risks not known or not reasonably foreseeable at this time. 3. I assume all the foregoing risks and accept personal responsibility for all expenses, medical or otherwise, following any such damages, injury, permanent disability or death. 4. I release, waive, discharge and covenant not to sue the Iowa Department of Natural Resources and Shelby County Conservation Board, its instructors, volunteers, directors, agents and other employees, other participants, sponsoring agencies, affiliates, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as “releasees”, from any and all liability to me my heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise. 5. This waiver may not be modified in any way. If any part of this waiver is determined to be invalid by law, all other parts of this waiver shall remain valid and enforceable. 6. 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.*

Yes, I understand and agree that submission of this form constitutes my electronic signatureNo
I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGNED IT VOLUNTARILY.*

Powered by Jotform SignClear
Yes, sign me up!No, thank you.
Should be Empty:

Paddle Event Registration - The Inkpaduta Canoe Trail (MAY 24TH, WANATA to THE PRAIRIE HERITAGE CENTER)