Visitor’s Acknowledgement Of Risks
WARNING: There are significant elements of risk in any adventure, sport or activity associated with the outdoors or wilderness, including but not limited to camping, climbing/hiking/trekking, fishing, hunting walking or glaciated terrain or surfaces, and the presence or use of saddle animals, dogs, watercraft, firearms and other weapons (referred to herein as “activity”), and the use of any related equipment.
In consideration of the services of Paul E Hansen dba:
Alaska Rainbow Adventures their officers, agents, employees, and
stockholders, and all other persons or entities associated with those businesses
(herein collectively referred to as “the outfitter/guide”), I agree as follows:
Although the outfitter/guide has taken reasonable steps
to provide me with appropriate equipment and/or skilled guides so I can enjoy an
activity for which I may not be skilled, the outfitter/guide has informed me
this activity is not without risk. Certain risks are
inherent in each activity and cannot be eliminated without destroying the unique
character of the activity. These inherent risks are
some of the same elements that contribute to the unique character of this
activity and can be the cause of loss or damage to my equipment, or accidental
injury, illness, or in extreme cases, permanent trauma or death.
The outfitter/guide does not want to frighten me or reduce my enthusiasm
for this activity, but believes it is important for
me to know in advance what to expect and to be informed of the inherent risks.
The following describes some
but not all, of those risks:
1) Falling; 2)
Cold weather and heat related injuries and illness including hypothermia,
frostbite, heat exhaustion, heat stroke, sun burn, and dehydration;
3) An “act of nature” which may include
avalanche, rock fall, inclement weather, thunder and lightning, severe and/or
varied wind, temperature or weather conditions; 4)
River crossings, fjordings, portaging, loading on to or unloading from a
variety of vehicles, craft, vessels, or animals, and/or travel to and from the
activity which may involve flying in small aircraft and landing/taking off from
in unimproved areas; 5)
Risk associated with crossing, climbing or down climbing of rock, snow and/or
ice – including risk of head injury which may be reduced by wearing a UIAA
approved helmet; 6)
Equipment failure and/or operator error; 7)
Risks typically associated with approaching, handling,
mounting/riding/dismounting, loading/unloading or the unpredictability of any
saddle or pack animal in response to light, movement, noise, or objects –
including risk of head injury which may be reduced by wearing an ASTM approved
riding helmet; 8)
Risks typically associated with watercraft including waterflow, current, tidal
action, or the wake of other craft; submerged, semi-submerged and overhanging
objects; capsizing, swamping or sinking of watercraft and resultant injury,
hypothermia, or drowning – drowning risks may be reduced by wearing a fastened
U.S.C.G. approved personal flotation device;
9) Attack or encounter with bears, reptiles, insects, or other animals;
10) Accidents or illness occurring in remote
places where there are no available medical facilities;
11) Fatigue, chill and/or dizziness, which
may diminish my reaction time and increase the risk of accident;
12) Discharge of weapons.
I am aware that the activity entails risks of injury or
death to any participant. I understand the
description of these inherent risks is not complete and that unknown or
unanticipated inherent risks may result in injury, illness, or death.
I agree to assume and accept full responsibility for the inherent risks
identified herein and those inherent risks not specifically identified.
My participation in this activity is purely voluntary.
No one is forcing me to participate, and I elect to participate in spite
of the inherent risks.
I acknowledge that engaging in this activity may require
a degree of skill and knowledge different from other activities, and that I have
responsibilities as a participant. I acknowledge
that the staff of the outfitter/guide has been available to more fully explain
to me the nature and physical demands of this activity and the inherent risks,
hazards, and dangers associated with this activity.
I certify that I am fully
capable of participating in this activity.
Therefore, I assume and accept full responsibility for myself, including all
minor children in my care, custody, and control, for bodily injury, death, loss
of personal property, and expenses as a result of those inherent risks and
dangers identified herein and those inherent risks and dangers not specifically
identified, and as a result of my/our negligence in participating in this
activity.
I have carefully read, clearly understood, and accepted
the terms and conditions stated herein and acknowledge that this agreement shall
be effective and binding upon myself, my heirs, assigns, personal
representative, and estate, and for all members of my family including minor
children.
Participants Name Printed:
_______________________________________________
Age ______________ Signature
___________________________________________
Emergency Contact
_____________________________________________________
Emergency Contact Phone Number ________ /
_______________________________
List of known allergies to plants, insects, food or
medications: ___________________
____________________________________________________________________
Describe if under a doctor’s care or taking
prescribed medications: ________________
______________________________________________________________________
If
This Activity involves the use of weapons, are you experienced with the safe
use of weapons? _____Yes
_____ No
If
“No”, have you passed an approved weapons safety class?
___ Yes ___ No
If Participant is under 18, the Parent or Legal Guardian must also sign: ___________________________________________