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Accident Waiver and Release of Liability
Accident Waiver and Release of Liability Form
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Name
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First
Last
Date (MM/DD/YYYY)
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Email
*
Phone Number
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upon hold Phone
Boat's
*
Select One
Single Kayak
Tandem Kayak
Canoe
PDF's
*
Select One
Yes
No
Personalized Flotation Devices
Drop Off / Pick Up Location
*
Select One
Red Top Mountain State Park
Lake Acworth / Acworth Beach (Cauble Park)
Custom
Emergency Contact Name
*
Emergency Contact Phone Number
*
Signature
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Signature for Minors – PARENT OR GUARDIAN FOR MINORS UNDER 18 The undersigned parent and/or natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child’s or ward’s participation in the recreational activities, and has agreed individually and on behalf of the child or ward, to the terms of the accident waiver and release of liability. The undersigned further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to act and release said parties on behalf of the minor and the parents or legal guardian.
Terms of Service
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I accept the terms of service – ORION FISHING CHARTERS, LLC ACCIDENT WAIVER AND RELEASE OF LIABILITY I acknowledge that participation in any recreational activities associated with Orion Fishing Charters, LLC including but not limited to fishing, swimming, camping, kayaking, canoeing, and/or tubing may test a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by fluctuating water levels, natural conditions, water current, terrain, facilities and transport to and/or from said facilities, temperature, weather, condition of the participants, equipment, actions of other people, including but not limited to participants, employees, guides, boaters, group leaders, and/or host of any group outings or events, and lack of hydration. These risks are not only inherent to participants, but are also present for volunteers, employees and guides. I hereby assume any and all risks of participating and/or volunteering in these activities. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them or because of their possible liability without fault. I certify that I am physically fit and have not been advised otherwise by a qualified medical person that I cannot participate. In consideration of my application and permitting me to participate in recreational activities associated with Orion Fishing Charters, LLC, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, release and discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me or my traveling to and from facilities or points of access, Orion Fishing Charters, LLC and its affiliates, their directors, officers, employees, volunteers, representatives, and agents. (B) Indemnify and hold harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of my or any actions during my participation in any recreational activities. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and/or illness during this event. I understand that at this event or related activities I may be photographed. I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers and/or assigns. The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I hereby certify that I have read this document and I understand its contents.
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