New Paddler | Aspen Kayak & SUP

Name *

First

Last

Parent's Name (if paddler is under 18 years old)

Phone Number *

Email *

Age, Height, Weight *

Emergency Contact Name *

Emergency Contact Phone Number *

Please list any medical conditions we should know about:

Prior Experience *

I have...

I'm Interested In...

River Kayak Sessions
Kayak Pool Sessions
SUP River Sessions
ACA Instructor Certification

Desired Date

Questions or Comments

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *

I AGREE

I am 18 or older. *

Yes
No

FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE {UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child's involvement or participation in these programs as provide above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law. *

I AGREE

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