MELMERBY ADVENTURES
WATER SPORTS PARTICIPATION UNCONDITIONAL GENERAL RELEASE FORM (SUPPLIMENTAL) FOR MINOR CHILDREN (UNDER 19)
NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN
READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE RELEASED USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM THE RELEASE IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE RELEASED HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.
In the activity may act in a negligent or intentional manner and contribute to the injury or death of the minor child. The scope of this supplemental waiver shall be coextensive with that of the Adult Participant Waiver to the fullest extent allowed by law.
NATURAL GUARDIAN'S ACKNOWLEDGEMENT OF LIMITED RELEASE ON BEHALF OF MINOR CHILD Your signature below reflects your express assent to be bound to the terms of this supplemental agreement for your minor child. Your signature also represents your attestation to being the natural guardian of the minor child(ren) listed below and possessing the legal authority to sign this agreement on their behalf. Please carefully review each section again and ensure that you fully understand the implications of this agreement.
This supplemental waiver for minor children waives your minor child's ability to recover against the Released for injuries, damages, or other loss occurring to the minor child, brought on behalf of the minor child by either you as natural guardian, personal representative or guardian based on the negligence of the Released.
By initialling this section and signing the waiver below, you are knowingly and voluntarily agreeing, and expressly acknowledging, that you have read the statement above regarding the waiver of your ability, as well as that of your minor child or his/her representative, to recover against the Released for any PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY.
Minor's Name (s)
Date of birth (s)
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Month
-
Day
Year
Date
Your signature below reflects your expressed consent to be bound to the terms of this agreement. Please carefully review each section again and ensure that you fully understand the implications of this agreement. Including the general release signed by yourself attached to this document.
INITIAL
SIGNATURE
DATE
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Month
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Day
Year
Date
EMERGENCY CONTACT:
The term natural risk or otherwise construed as an "inherent risk of the activity means those dangers or conditions, known or unknown, which are characteristic of, intrinsic to, or an integral part of the activity and which are not eliminated even if the activity provider acts with due care in a reasonably prudent manner. The term includes but is not limited to the failure by the WATER SPORTS provider to warn the natural guardian or minor child of an inherent risk; and the risk that the minor child or another participant
RELATIONSHIP
NAME
PHONE NUMBER
Format: (000) 000-0000.
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