Escape from Zomgaup

Name *

Email *

Address

City/Town

State

Zip Code

Phone

PARTICIPANT RELEASE OF LIABILITY WAIVER Escape from Zomgaup event. In consideration of being allowed to participate in any way in this Kayak and Canoe Club of New York (KCCNY) organized event, the undersigned acknowledges, appreciates, and agrees that: The risk of injury or illness from the activities involved in this sport is significant, including the potential for permanent paralysis and death; and while particular rules, equipment, and personal discipline mayreduce this risk, the risk of serious injury or illness does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEE'S or others and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation. If I observe any unusual or significant hazard during my presence or participation I will remove myself from the activity and bring such hazard to the attention of the nearest trip cordinator or team leader immediately. I verify that I will only participate in club activities, on and off water, while in good physical and mental health and that I will not consume any mind altering drugs or alcohol prior to or during club activities that may impede my ability to participate putting myself or others at risk. I will inform the trip coordinator or team leader at the beginning of any on water activity if I am not feeling well or have a medical condition and remove myself from the activity. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS KCCNY; their officers & directors, officials, agents, and/or employees, other participants, sponsoring agencies, commissions, sponsors, advertisers, volunteers, coaches, steerers, and, if applicable, owners and lessors of premises and equipment used to conduct club activities (“RELEASEE'S”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHERARISING FROM THE NEGLIGENCE OF THE RELEASEE'S OR OTHERWISE. I also acknowledge that photographs and videos may be taken of me in my participation in, and attendance during, club activities that may be used for training purposes or club promotions. I will notify trip coordinators or organizers if I choose not to participate in a photograph or training video.

I certify that I am over 18 years of age.

Comments (please address questions directly to coordinator or using the contact us form on this website)