Form Liability Waiver PLEASE FILL OUT AND SIGN! Name*Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*2020 **READ CAREFULLY!** Killinit Kayaks Inc. Waiver and Release of Liability In consideration of the services of Killinit Kayaks Inc., their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (collectively “Killinit Kayaks Inc.”), I hereby agree to release, indemnify, and discharge Killinit Kayaks Inc., on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows: I acknowledge that canoeing, kayaking, and or paddleboarding entails known and unanticipated risks which could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: my boat could turn over and/or I could have to swim risking entanglement in trees; exposure to the natural elements can be uncomfortable and/or harmful; I am aware that this exposure could cause sunburn, dehydration, heat exhaustion, heat stroke, and heat cramps; also prolonged exposure to cold water can result in hypothermia; exposure to potentially dangerous wildlife, insects, plants; and accidental drowning is also a possibility. I also know that there is a risk of equipment malfunction or injury due to third parties. Furthermore, I understand Killinit Kayaks Inc. employees are qualified, but have difficult jobs to perform. They seek safety, but they are not infallible. No one can predict the weather, the elements, or the terrain with 100% accuracy. I am cognizant of the basic safety rules and instructions concerning these water activities. I also understand that it is not the purpose of Killinit Kayaks Inc. to teach safety rules. I also understand that I am responsible for the safety and good operating condition of any equipment while I use such equipment. I agree that if I do not fully understand the warnings or instructions given, that I will immediately inform Killinit Kayaks Inc. employees before proceeding further. I expressly agree and promise to accept and assume all the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate despite the risks. I understand that it is my sole responsibility to consult with a physician prior to and regarding my participation. I represent that I do not have a medical condition that would prevent full participation in this activity. Should I develop a condition that prevents full participation or otherwise limits my activity, I agree to that my continued participation is my sole responsibility and choice. In consideration for being allowed to participate with Killinit Kayaks Inc. and other good and valuable consideration, I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Killinit Kayaks Inc. from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Killinit Kayaks Inc.'s equipment or facilities, including any such Claims which allege negligent acts or omissions of Killinit Kayaks Inc. I agree not to sue regarding any claim that I, my family, heirs, legal representatives, and assigns may have against Killinit Kayaks Inc. or any other instructor or employee thereof for any claim for injury, death, or other damages that I may sustain as result of participating. I understand and agree that Killinit Kayaks Inc., its owners, employees, independent contractors, staff, volunteers, advisors, and agents may not be held liable in any way for any occurrence with this Program that may result in injury, Should Killinit Kayaks Inc. or anyone acting on their behalf be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. Should I or my successors assert any claim in contravention to this agreement, I and my successors shall be liable for the expenses including legal fees and costs incurred by Killinit Kayaks Inc. in defending such claim. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical conditions which could interfere with my safety in this activity, or else I am willing to assume - and bear the costs of --all risks that may be created, directly or indirectly, by any such condition. I understand that I may be the subject of the media publicity and promotion. In consideration for being allowed to participate and other good and valuable consideration, I agree and authorize Killinit Kayaks Inc. to exhibit, with or without advertising sponsorship, as still photographs, transparencies, motion pictures, television, video, verbal statements, voice, portrait, and pictures. I authorize my name, voice, statements, and images may be used in such promotional materials and website. I release Killinit Kayaks Inc., as well as any assignees, from any and all claims for damages for libel, slander, invasion of privacy or any other claim based on use of the above described materials. I acknowledge that Killinit Kayaks Inc. has no control over outside media use of pictures and statements taken without permission and agree to hold Killinit Kayaks Inc. harmless for such use. In the event that I file a lawsuit against Killinit Kayaks Inc., I agree to do so solely in the state of Ohio, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Killinit Kayaks Inc. based on any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION (Must be completed for participants under the age of 18!) I warrant that I am the parent and/or legal guardian of this minor. By my signature below, I warrant that I have the right, power and authority to enter into this Agreement and I have completely read and fully understand this Agreement and agree to be bound hereby, and to cause this minor to comply therewith. In consideration ofminor(s) listed below or*all that apply ("Minor") being permitted by Killinit Kayaks Inc. to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless Killinit Kayaks Inc. from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.Please list all minor's names...*If no minors just type in N/A...Consent* I agree to the Waiver and Release of Liability policy.Signature(s)*Today's Date* Date Format: MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.