SHEEP DOG IMPACT ASSISTANCE

OUTDOOR ADVENTURE RELEASE AND WAIVER OF LIABILITY FORM

 

This Release and Waiver of Liability Form (hereinafter the “Release”) is executed this          day of                                             , 20      , by                                                       (hereinafter the “Participant”) in favor of SHEEP DOG IMPACT ASSISTANCE, a nonprofit corporation organized and existing under the laws of the State of Arkansas, along with its directors, officers, employees, members, agents, affiliates, and Participants (hereinafter collectively “SDIA”). For good and valuable consideration, receipt of which is hereby acknowledged, Participant and SDIA agree to the following:

 

  1. Outdoor Activities: Participant acknowledges and is aware that SDIA sponsors and engages in certain outdoor experiences including, but not limited to, adventure/obstacle races, camping, hiking, canoeing, boating, fishing, four-wheeling, hunting, marathons, scuba diving, rock-crawling, etc., (hereinafter collectively “Outdoor Activities”). PARTICIPANT ACKNOWLEDGES THE ACTIVITIES IN THE PRECEDING SENTENCE ARE NOT EXHAUSTIVE AND THAT THIS RELEASE APPLIES TO ANY ACTIVITY PARTICIPANT MAY BE INVOLVED WITH THROUGH SDIA. Participant further acknowledges and is aware that SDIA may at times contract with independent contractors to provide transportation services, guide services and/or other related services in sponsoring and engaging in said Outdoor Activities.
  2. Waiver and Release of Liability: Participant, for myself and for my heirs and assigns, hereby waives, releases and agrees to forever indemnify and hold harmless SDIA and its affiliates, agents, members, employees, volunteers, officers, directors, independent contractors, successors and assigns for any and all claims, causes of action, losses, or liabilities of any nature that may arise as a result of my participation in any Outdoor Activities with SDIA. This includes any and all claims for property damage, illness, bodily injury, personal injury, and/or death, even if such damage, illness, injury or death is caused by any of the parties’ negligence listed in the preceding sentence. This also includes any and all claims for strict liability for abnormally dangerous activities. If Participant is a minor, Parent/Guardian who executes below accepts full responsibility for the care and supervision of the minor during these activities. Further, I acknowledge and understand SDIA assumes no responsibility, and has no obligation, to provide financial or other assistance including, but not limited to medical, health or disability insurance in the event of property damage, illness, bodily injury, personal injury or death.
  3. Assumption of Risk: Participant acknowledges that by engaging in Outdoor Activities with SDIA, said Outdoor Activities may be hazardous to me. I further acknowledge and understand that some situations may involve, and likely will involve, inherently dangerous activities and that I may be exposed to dangers and hazards, including negligence by others. I, for myself and for my heirs and assigns, expressly and specifically assume any and all risks of injury or harm, including death, and release and hold harmless SDIA from all liability for property damage, illness, bodily injury, personal injury, and/or death resulting from any Outdoor Activities engaged in while serving as a Participant with SDIA. Participant further acknowledges that SDIA has no responsibility regarding medical advice, medications, or other medical determinations that your doctor may deem necessary for your safe participation during any Outdoor Activities with SDIA. Participant acknowledges SDIA assumes no responsibility for providing medical care or treatment while Participant is engaged in Outdoor Activities with SDIA. Participant expressly acknowledges that SDIA has no control over and assumes no responsibility for the actions of any independent contractors providing any services related to Participant’s participation in any Outdoor Activities with SDIA.
  4. Insurance: Participant acknowledges that SDIA does not maintain, carry or provide property, health, medical or disability insurance coverage for Participant, and further acknowledges that SDIA expressly disclaims responsibility for providing property, health, medical or disability insurance coverage for Participants participating in any Outdoor Activities with SDIA.
  5. Insurance Requirements: SDIA EXPECTS AND ENCOURAGES PARTICIPANT TO CARRY BOTH LIABILITY AND MEDICAL/HEALTH INSURANCE PRIOR TO PARTICIPANTING IN OUTDOOR ACTIVITIES WITH SDIA.
  6. Medical Treatment: Should Participant require any medical treatment, medical services or first-aid treatment while participating in any Outdoor Activities with SDIA, Participant, for itself and its heirs and assigns, agrees to forever release, discharge and indemnify SDIA from any claim whatsoever which arises as a result of said medical or first-aid treatment in connection with participation in any Outdoor Activities with SDIA.  Participant agrees to provide any and all medical history if emergency medical treatment is required and further acknowledges that hospital facilities are often unavailable and evacuation to hospital facilities could be prolonged, difficult and expensive. Participant agrees to pay all costs related to emergency evacuation and medical treatment if those services are needed.
  7. Photographic Release: Participant grants and conveys unto SDIA all right, title and interest in any and all photographic images and video or audio recordings made by SDIA while serving as Participant. SDIA will have the right to freely reproduce, publish and/or circulate any photographic images and video or audio recordings in their sole discretion.  Participant acknowledges that Participant will not be entitled to any compensation, including, but not limited to any royalties, proceeds or other benefits derived from such photographs or recordings.
  8. Current Health: Participant acknowledges that they have no known physical or mental conditions that would impair their capability to fully participate as intended or expected by SDIA. Participant shall disclose any medical or psychological conditions to SDIA prior to engaging in, or departure to, any Outdoor Activities associated with SDIA. SDIA retains the right to disqualify any Participant at any time if they deem the Participant mentally or physically incapable of participating, continuing, or completing any Outdoor Activities associated with SDIA.
  9. General Health & Wellness: Participant acknowledges and agrees to abide by guidance and directives provided by State, National & Federal departments/agencies, and Centers for Disease Control (CDC), pertaining to maintaining the health and safety of all during natural disasters, unexpected crises and national pandemics.
  10. Indemnification: Participant promises to indemnify, hold harmless and defend SDIA against any and all claims for Participant’s own negligence, and any other claim(s) arising from Participant’s conduct during any Outdoor Activities. Participate shall reimburse SDIA for any damages, settlements and defense costs, including attorney’s fees, that SDIA incurs because of any such claim made against them. Participant agrees that in the event of Participant’s death or disability, the terms of this Release, including this indemnification obligation, will be binding on Participant’s estate, and Participant’s personal representative, executor/executrix, administrator, trustee, or guardian will be obligated to respect and enforce them.
  11. Severability: Participant agrees that should any clause or part of a clause within this Release be found unenforceable, the remaining provisions of any affected clause and all remaining clauses shall still apply and remain enforceable.
  12. Choice of Law: Participant agrees that this Release shall be interpreted under the laws of the State of Arkansas, and that any legal proceeding brought by Participant shall be brought in Benton County, Arkansas.
  13. Other: I, as Participant, acknowledge it is my free and voluntary desire to participate in Outdoor Activities with SDIA. I further acknowledge that I have read this Release and fully understand the potential dangers and risks associated with my participation in said Outdoor Activities.

 

This Release is being executed as a result of my free and voluntary desire, and without any duress.  To further acknowledge my understanding of this Release, I have executed this with a witness.

 

Participant Information:

Name:                                                                                     Phone:                                                

Email:                                                                                     DOB:                                                 

Mailing Address:                                                                                                                               

 

Signature:                                                                                Date:                                                  

*To be signed by Parent/Guardian if Participant is under 18 years old

 

 

Emergency Contact:

Name:                                                                                     Relation:                                            

Phone:                                                                        

 

Witness Information:

 

Name:                                                                                     Date:                                      

Signature:                                                                   

 

 

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