Participant Release of Liability and Assumption of Risk Agreement
Organization Name (the Host): KAYAKANT LLC (DBA Kayak ANT), 45 Ada St, Tarpon Springs, FL 34689
Participant Full Name (Print):
Date of Birth (MM/DD/YYYY):
PLEASE READ CAREFULLY, THIS IS AN OFFICIAL DOCUMENT. The business of KAYAKANT LLC (doing business as Kayak ANT and hereafter referred to as such) includes services, rentals, purchases or leases of Kayak ANT, and/or the utilization of the facilities, premises and equipment of Kayak ANT, in engaging in canoeing, kayaking, stand up paddle boarding and other open water or sports activities (hereinafter referred to as “WATER ACTIVITIES”).
I understand and agree that Kayak ANT, nor any of their owners, members, officers, directors, agents, employees, volunteers and all other persons or entities acting in any capacity may be held liable or responsible in any way for any injury, death or other damages to me or my family, estate, heirs or assigns that may occur as a result of my participation in WATER ACTIVITIES or as a result of the negligence of any party, including the Kayak ANT, whether passive or active.
I, for myself, my heirs, executors, administrators and representatives do hereby release, exempt, hold harmless, indemnify and covenant not to file any liability, loss, claim, demands and possible causes of action in any way resulting from or arising out of or in association with my participation in WATER ACTIVITIES whether arising from my negligence, gross negligence or intentional conduct or the negligence, gross negligence or intentional conduct of any of Kayak ANT.
I understand and agree that I am not only giving up my right to sue Kayak ANT, but also any rights my heirs, assigns or beneficiaries may have to sue Kayak ANT. I further represent that I have the authority to do so and that my heirs, assigns or beneficiaries will be stopped from claiming otherwise because of my representations to Kayak ANT.
I understand and acknowledge that WATER ACTIVITIES is an action sport and a physically strenuous activity and that I will be exerting myself during this activity and that if I am injured as a result of heart attack, panic, hyperventilation, drowning or any other cause whatsoever, that I expressly assume the risk of said injuries and that I will not hold Kayak ANT responsible for the same.
I acknowledge outdoor activities, WATER ACTIVITIES, including instruction and travel to such activities, entail known and inherent risks, as well as unknown and unanticipated risks which could result in serious emotional or physical injury, paralysis, death, drowning or damage or loss to myself, third parties and my own or others property. I understand such risks cannot be eliminated without jeopardizing the essential qualities of the activity.
I understand Kayak ANT staff have difficult jobs to perform. They seek safety but are not infallible. They might not be aware of a participant’s abilities. They might misjudge the weather, the elements, terrain, trail or river route location. They may give insufficient warnings or instructions and the equipment being used might malfunction.
Should Kayak ANT or anyone acting on its behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify them for all such fees and costs. I agree that this document and all other aspects of my relationship with Kayak ANT are governed by the laws of the State of Florida, and that any legal action resulting from my participation in this activity shall be brought only in Volusia County, Florida. In the event that any portion of this agreement is deemed invalid or unenforceable, all other portions of this agreement shall remain in full force and effect.
I am in good mental and physical health and am not under the influence of alcohol or any drugs. I 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 will be participating in WATER ACTIVITIES with marine life and wildlife. I understand and acknowledge that these are wild animals and their behavior cannot be predicted or controlled. I understand that if I am injured by any such marine life or wild life, regardless of the cause, I will not hold Kayak ANT responsible for any such injury or death.
I will inspect all my equipment prior to the WATER ACTIVITIES and will notify Kayak ANT or their employee, agent conducting the WATER ACTIVITIES, if any of the equipment is not working properly. I will not hold the released parties responsible for my failure to inspect equipment prior to the WATER ACTIVITIES. I hereby represent that I will observe all applicable rules set forth by Kayak ANT and that I will conduct myself in a safe and prudent manner so as not to endanger the lives of persons or property of any individual. I understand that if I do not follow safety rules, my participation in the WATER ACTIVITIES will be immediately terminated.
I understand that I am not entitled to any form of reimbursement or refund for cancellation or me not entering the water.
I acknowledge and agree that I am responsible for any loss, theft, or damage to any kayak, paddle, life jacket, or other equipment rented or provided by Kayak ANT for use during the WATER ACTIVITIES that occurs through my personal negligence.
In the event of loss or damage that occurs as a result of my personal negligence, I agree to pay for the cost of repair or replacement at fair market value. I further authorize Kayak ANT to charge any such repair, replacement, or rental costs to the credit card on file.
I further state that I am at least 18 years of age. I understand that individuals who are members of a vulnerable population — including but not limited to minors, persons with disabilities, and those who are legally incapacitated — must be accompanied by a parent, legal guardian, or legal representative in order to participate in any WATER ACTIVITIES. As the parent, legal guardian, or legal representative of such a participant, I voluntarily assume all risks associated with their participation. I further waive and release any and all legal rights that may accrue to me, to my minor child, or to the individual for whom I am the legal guardian or legal representative, as a result of any injury, harm, or damages that may be sustained by me, my minor child, or the individual for whom I am the legal guardian or legal representative while engaging in the WATER ACTIVITIES.
Please read and be certain you understand the implications of signing Express Assumption of Risks associated with the WATER ACTIVITIES.
EXPRESS ASSUMPTION OF RISKS I do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with the WATER ACTIVITIES to which I am about to engage, including but not limited to:
Risk of injury from the activity and equipment utilized in the WATER ACTIVITIES is significant including the potential for permanent disability and death.
WATER ACTIVITIES falls may cause cuts, broken bones and other injuries including death. Exposure to hidden or obvious obstructions and/or debris found in oceans, lakes, rivers and tributaries can cause drowning or other harm or death.
Possible equipment failure and/or malfunction of my own or other equipment.
Running into objects, persons or animals including but not limited to fallen trees, motorized watercrafts, barely submerged logs and stumps and other hazards that are not visible.
My own negligence and/or the negligence of others, including employees, agents, independent contractors or representatives of Kayak ANT, including but not limited to operator error.
Hazards related to WATER ACTIVITIES which include but are not limited to: collision, falling off of, or other hazards that may result in wetness, injury, exposure to elements, hypothermia, impact of the body upon the water, upon rocks, injection of water into my body orifices, marine life forms and/or drowning.
Cold weather and heat related injuries and illness including but not limited to frost nip, frostbite, heat exhaustion, heat stroke, sunburn, hypothermia and dehydration.
Exposure to outdoor elements, including but not limited to: inclement weather, thunder and lighting, severe and/or varied wind, temperature or weather conditions. • Attack by or encounter with insects, reptiles and/or animals.
Accidents or illness occurring in remote places where there are no available medical facilities.
Fatigue, chill and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.
My sense of balance, physical coordination and ability to follow instructions. I understand the terms herein are contractual and that I have signed this agreement of my own free act and with the knowledge that I hereby agree to waive my legal rights.
CANCELLATION AND REFUND POLICY
I acknowledge the Host’s cancellation and refund policy as stated in the attached statement of understanding.
HEALTH STATEMENT
I will notify the Host ownership or employees if I suffer from any medical or health condition that may cause injury to myself, others, or may require emergency care during my participation.
MEDIA RELEASE STATEMENT
The Hosts, and their partners, agents, representatives, assigns, and licensees, are granted the irrevocable right and permission to photograph, videotape, audiotape, and/or otherwise record the participant during the guided kayak trip.
The participant understands and agrees that these images and recordings ("Media") may be used without further compensation for any lawful purpose, including but not limited to:
Promotional and marketing materials (print, online, social media).
Educational or training purposes.
The participant waives any right to inspect or approve the uses to which the Media may be put by the Hosts.
The participant acknowledges that the Hosts will rely on this permission and hereby releases and discharges the Hosts from any and all claims and demands arising out of or in connection with the Media, including any claims for libel, invasion of privacy, or emotional distress.
VENUE
The Venue of any dispute that may arise out of this agreement or otherwise between the parties to which the Host or its agents is a party shall be either the City of Tarpon Springs, Florida, Justice Court, or the County or State Supreme Court in Pinellas County, Florida.
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.
Signature:
Date (DD/MM/YYYY):
Typed/Printed Name:
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 provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
Signature of Parent/Guardian of Minor Age Participant:
Date Signed (DD/MM/YYYY):
Typed/Printed Full Name of Parent/Guardian:
Full Name of Minor Age Participant: