L.A. County Department of Parks & Recreation Waiver


LOS ANGELES COUNTY

DEPARTMENT OF PARKS AND RECREATION

WAIVER AND RELEASE OF LIABILITY,

ASSUMPTION OF RISK, AND INDEMNIFICATION

DRAGON BOAT PRACTICE AND SPECIAL EVENTS

 

Paddling dates include but are not limited to: January 1, 2017 – December 31, 2017

In consideration of being allowed to participate in any way with DRAGON BOAT PADDLING ACTIVITY at Santa Fe Dam or other Los Angeles County Parks and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist; and,

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or other and assume full responsibility for my participation.

THESE RISKS INCLUDE, BUT ARE NOT LIMITED TO: BOAT CAPSIZE; TIDAL CONDITIONS AND CURRENTS; COLLISION WITH OBJECTS OR OTHER WATERCRAFT; PROLONGED EXPOSURE TO COLD WATER, HYPOTHERMIA, AND ACCIDENTAL DROWNING; ILLNESS IN REMOTE AREAS; EXPOSURE TO SUN, STRONG WIND, STORMS, WAVES AND LIGHTNING;AGGRESSIVE AND/OR POISONOUS MARINE LIFE OR FRESHWATER ANIMALS; WRIST, ARM, SHOULDER, AND/OR BACK INJURIES; SLIPS AND FALLS; RAPIDLY CHANGING ADVERSE WEATHER AND WATER CONDITIONS; INADEQUATE WARNINGS OR INSTRUCTIONS (IF ANY); AND THE MALFUNCTION OF BOATS OR EQUIPMENT.

I certify that I have insurance to cover any injury or damage I may cause or suffer while participating, and I agree to solely bear the costs of such injury or damage. I further certify that I am willing to assume the risk of any medical or physical condition I may have.

If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS  the Los Angeles County, the Los Angeles County Parks & Recreation Department , the Los Angeles County Sheriff’s Department, Army Corps of Engineers, or any organizations or partners, their officers, officials, volunteers, agents, and/ or employees, other participants, sponsoring agencies, sponsors, advertisers (“RELEASES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.

I HAVE READ, UNDERSTAND AND HAVE HAD SUFFICIENT OPPORTUNITY TO CONSIDER THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT; I UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Signature

Date

Name

DOB:

Email

Phone No:

Address

Emergency Contact

Emergency Phone No:

IF PARTICIPANT IS UNDER 18 YEARS of AGE
PARENT OR GUARDIAN’S ADDITIONAL INDEMNIFICATION
I hereby give my consent for the above named minor to participate in the Activities defined above. I, the undersigned, hereby release and discharge the Los Angeles County Department of Parks and Recreation, the County of Los Angeles, Los Angeles County Sheriff’s Department or any organizations or partners, their officers, officials, agents, and/ or employees, other participants, sponsoring agencies, sponsors, advertisers and each entity’s agents, owners, Officers, volunteers, participants, employees, coaches, instructors, and all other persons or entities acting in any capacity on their behalf, From all liabilities associated with any and all claims related to such Activity that may be filed on behalf of or for the above named minor. For the purposes of this agreement, liability means all claims, demands, losses, causes of action, suits or judgments of an and every kind that occurs during the above-described activity and that results from any cause.

Parent/Guardian Signature

Date:

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