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PARTICIPANT WAIVER & RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT (this “agreement”)
***READ CAREFULLY AND COMPLETELY BEFORE SIGNING***

In consideration of being allowed to participate in any Fort Pierce Outdoor Center (here after referred to as FPOC) program, event or activity (collectively the “Activities”), I, the undersigned, hereby confirm that I fully understand, acknowledge and agree as follows:

1. ACTIVITY PARTICPATION AND EQUIPMENT ACKNOWLEDGEMENT

The hazards and risks of injury from the Activities are significant including, but not limited to, damage to person and property, serious bodily injury, fatigue, limb injury, muscle injury, dehydration, drowning, bacterial infection, abrasions, cuts, permanent paralysis and loss of life; I assume all such risks, both known and unknown, whether arising from, relating to or in connection with any act, omission, recklessness, negligence or gross negligence of FPOC or others; I assume full responsibility for my participation; and I agree that FPOC is not and will not be responsible or liable for any such damage, injury, paralysis or loss of life. I will comply with any and all of FPOC’s terms and conditions of my participation in the Activities including, but not limited to, any FPOC trip plan or suggested route for the Activities which I will follow, failing which I will immediately reimburse FPOC for any rescue efforts FPOC may determine to be necessary or appropriate. If I observe, realize or perceive any uncomfortable, unusual or significant hazard or risk during my participation, I will remove myself immediately from participation and immediately bring that hazard or risk to the attention of FPOC. The use, by me, of any equipment (the “Equipment”) provided by FPOC constitutes my acceptance of the Equipment, on a temporary lease basis in “As Is” condition, without any representation or warranty whatsoever. I will immediately pay FPOC for any damage, destruction or loss of any of the Equipment. If I fail to return to FPOC any or all of the Equipment, I will immediately reimburse FPOC for the full replacement cost of the unreturned Equipment and, if FPOC has made any effort to search for or locate the unreturned Equipment, I will immediately be charged with the card used. If I did not pay by card I will reimburse  immediately upon FPOC giving me the amount. I agree not to harass, touch, chase, or otherwise cause  damage, either knowingly or inadvertently to  any wildlife I encounter.

 

2. INDEMNITY AND RELEASE

I, for myself and my heirs, beneficiaries, personal representatives, successor, assigns and all other persons (the “Releasors”), will defend (with attorneys acceptable to FPOC), release, indemnify, and hold harmless FPOC and any all of FPOC’s officers, directors, officials, volunteers, agents, representatives, employees, independent contractors, subcontractors, third-party vendors, concessionaires, other participants, sponsors, advertisers and owners and lessors of any premises, facilities or equipment used in the Activities, and their successor and assigns (collectively, the

“Releasees”), from and against any and all liabilities, claims, demands, damages, losses, costs and expenses (including, but not limited to, attorneys’ fees and costs through all appellate and post-judgment proceedings including, without limitation, any bankruptcy proceedings) arising from, related to or in connection with the Activities and any damage, harm, injury or death recklessness, negligence or gross negligence of any of the Releasees or otherwise, directly or indirectly, to the fullest extent permitted by law. If any provision of this Agreement is determined to be unenforceable for any reason, all other provisions of this Agreement will remain in full force and effect. The provisions of this Agreement will survive any termination, cancellation, expiration or conclusion of the Activities. This Agreement incorporates the entire understanding and agreement between me and FPOC, and any modification of this Agreement accordance with the laws of the State of Florida, and the venue for any litigation or other legal proceedings will be in Palm Beach County, Florida. 

3. MEDIA RELEASE

FPOC may use any and all photographs, videos, slides, digital files and any other images of me in any advertising, marketing, display, publication, website or any other media, or for any other purpose or use, obtained, created, produced or reproduced for, by or in connection with FPOC or the Activities, and any and all such photographs, videos, slides, digital files and other images including, without limitation, any and all copyright and other rights, will belong to and remain the exclusive property of FPOC. 

4. DECLINING FORMAL INSTRUCTION

The Fort Pierce Outdoor Center offers instructional programs that can provide valuable skill sets to the participants, especially beginners. By initialing here I am acknowledging that I am aware of this option and am waiving the opportunity to take advantage of such training. I have the necessary knowledge to safely navigate the waterways I will be traveling in, with the equipment I am issued, under the conditions present at the onset of the activity. 

5. NOTICE TO THE MINOR CHILD’S PARENT OR NATURAL GUARDIAN

YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF FPOC USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM FPOC IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE FPOC HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

I have read or had Items 1-5 in  this Agreement read to me; I fully understand, acknowledge, and agree to all of the provisions of this Agreement; I fully understand, acknowledge and agree that I have waived and released forever important and substantial rights by signing this Agreement; and I sign this Agreement freely and voluntarily, without any inducement or coercion.  

I Agree

 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
11 Participant's Name

First Name*

Middle Name

Last Name*
11 Participant's Date of Birth*
Parent or Guardian's Email Address

Email
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A signed copy of this waiver will be sent to the email address you provide.
Participants Activity:
Activity:*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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