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

PARTICIPANT RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

ln consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree that:

I . The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death .

2. I KNOWLINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my participation.

3. I willingly agree to comply with terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.

4. I for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE ASPEN KAY AK AND SUP ACADEMY its officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any INJURY, DISABILITY OR DEATH I may suffer, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

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

By signing electronically below, I consent to this agreement. I understand that if I choose not to sign below, I cannot participate.

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

Parent or Legal Guardian Signature *

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PARTICIPANT RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT