Buena Vista Audubon Society
Pelagic Trip Acknowledgement Of Risks And Release Form
Print full legal name of participant: __________________________________________________________
RISKS: I understand that when participating in any Buena Vista Audubon Society pelagic trip there are many inherent risks, hazards and dangers. An example of some (but not all) of the many risks of going to sea include (a) walking and standing surfaces that may be wet, slippery, moving, irregular, unstable and rough; (b) open areas such as hatches into which I could fall, (c) low or no lighting (d) objects and equipment that could fall on me when the boat lurches (e) low ceilings (f) ropes, chains, and other items that could strike or entangle me (g) extreme and variable physical weather and ocean conditions, including darkness, sun glare, storms, and hot and cold temperatures, large waves (h) vessels, docks, buildings, ladders, bunks, and stairs from which I could fall (i) vessels and docks that could pitch, roll, capsize, flood, collide, and sink (j) gaps between the vessel and a dock that could open or close suddenly and unpredictably (k) encounters with fish, birds and marine mammals (l) lurching steps and stairs (m) unavailability or absence of medical facilities, medical attention, medical expertise and medical treatment (n) risk of personal injury or death (o) damage to, loss of or theft of my property while traveling to and from the boat, while parked at the boat landing, or while participating in the trip (p) accidents, criminal activity and physical exertion to name just a few.
ACKNOWLEDGEMENT OF RISKS: In consideration of being allowed to participate on Buena Vista Audubon Society pelagic trips, I voluntarily assume all risks associated with participating in such a trip - from any cause whatsoever - even if caused by the negligence or other misconduct of Buena Vista Audubon Society, its trip leaders, anyone else acting on behalf of Buena Vista Audubon Society, any other participant on the trip, or any third parties or other causes.
RELEASE: I agree to release Buena Vista Audubon Society, its trip leaders and all others acting on its behalf from any claim for damages of any kind, whether injury, death, or damage to, or loss/theft of property caused as a result of participating in this trip. By signing below I certify that I have carefully read this document and fully understand it is a total release of liability. I confirm that I am waiving any right I may have to bring a legal action to assert a claim against Buena Vista Audubon Society, its trip leaders and anyone else acting on behalf of Buena Vista Audubon Society whether based on negligence or any other theory.
Participant signature: ________________________________________________ Date: ___________
Participant birth date: (Month) ________________ Day: ____________ Year: ____________
Participant’s under 18: Print Guardian’s Full name: ______________________________________________
Guardian’s signature: __________________________________________________ Date: ___________
Participant address/zip: ____________________________________________________________________
Emergency contact & phone number #1: _______________________________________________________
Emergency contact & phone number #2: _______________________________________________________
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