Paddlers for Humanity
Accident Waiver and Release of Liability:
I am applying for entry into a Paddlers for Humanity Fund-Raiser Paddle Event (or the “event”). I hereby assume all of the risks of participating in, volunteering for and/or escorting this event. I realize that liability may arise from passive or active negligence on the part of the Released Parties (as defined below) and from dangerous or defective equipment or property owned, maintained and/or controlled by individuals associated with the event. I realize this is an open ocean event subject to tides, currents, waves, wind, and marine hazards (animate and inanimate) of all types. I fully realize that this event is an extreme test of a person’s physical and mental limits and that events of this nature entail a great deal of risk to me, including serious injury and even death. I also realize that this event could not be held unless I am willing to assume all consequences of these risks. These risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, lack of hydration, vehicular traffic, and actions of other people. Therefore, I voluntarily assume full responsibility to inform myself as to all the dangers and risks and I sign this Accident Waiver and Release of Liability (or the “waiver”) as a legally binding method of personally assuming all of these risks. This Accident Waiver and Release of Liability shall apply to all claims, including those arising out of passive or active negligence.
I have read and understand the above (Initial Here): _______
In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, legal representatives, and assigns as follows: (A) waive, release, and discharge Paddlers for Humanity, the Town of East Hampton, the County of Suffolk, the State of New York, its directors, officers, employees, volunteers, representatives, agents, event holders, event sponsors, event directors, and event volunteers (hereinafter collectively referred to as “Released Parties”) from any and all liability for my death, disability, personal injury, property damage, property loss, or actions of any kind which may hereafter accrue to me during the event or in connection with activities associated with the event; and (B) indemnify and hold harmless the Released Parties from any and all liabilities or claims made as a result of participation in this event, whether caused by passive or active negligence or otherwise.
I have read and understand the above (Initial Here): _______
I attest that I am physically fit, have sufficiently trained for participation in the event, and have not been otherwise advised by a qualified medical person. I acknowledge that I have no mental or physical condition that to my knowledge would endanger myself or others if I participate in the event.
I have read and understand the above (Initial Here): _______
I understand that this is an open ocean event and there will be no qualified medical care available.
I have read and understand the above (Initial Here): _______
I have read all rules and requirements for the Paddlers for Humanity Fund-Raiser Paddle Event and agree to comply with all rules and requirements. I understand that failure to comply would constitute negligence on my part.
I have read and understand the above (Initial Here): _______
This Accident Waiver and Release of Liability will continue in full force and effect even after the termination of the activities conducted by or for the benefit of Paddlers for Humanity, whether by agreement, by operation of law, or otherwise. This Accident Waiver and Release of Liability is governed by the laws of the State of New York and is intended to be as broad and inclusive as is permitted by law. If any provision of this Accident Waiver and Release of Liability is held invalid or unenforceable by a court of competent jurisdiction, the remaining provisions will continue to be fully effective. This waiver contains the entire agreement between the parties, and supersedes any prior written or oral agreements concerning the subject matter.
I have read and understand the above (Initial Here): _______
I hereby certify that I have read this document and all accompanying rules and safety recommendations. I understand and agree to indemnify and hold harmless the Released Parties from and against any and all liabilities, claims, actions, damages, costs or expenses of any nature whatsoever, whether in law or equity, known or unknown, incurred by Released Parties and arising out of or in any way related, directly or indirectly, to participation in the event. By applying for entry in this event, I voluntarily agree to the terms outlined in this Accident Waiver and Release of Liability. I also agree to abide by all Paddlers for Humanity policies and procedures.
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Print Participant’s Name Participant’s Signature
Age Date
If the participant is a minor:
I certify that I am the parent or guardian of the minor participating in the event and have the right to waive the participant’s rights that are waived above. By signing below and initialing above, I am waiving the participant’s rights with the same effect as if the participant had not been a minor and had signed on his/her behalf. I agree to indemnify and hold harmless the Released Parties associated with the program, from and against any and all liabilities, claims, actions, damages, costs or expenses of any nature whatsoever, whether in law or equity, known or unknown, incurred by the Released Parties and arising out of or in any way related, directly or indirectly, to participation in the event.
_____________________________________ ____________________________
Name of Minor Participant Signature of Parent/Guardian
Age Date
Please mail this signed form to:
P.O. Box 2555
East Hampton, NY 11937
Or scan and e-mail signed form to:
Photo/Video Release:
I hereby give permission for images of myself, at the event and other related activities, captured through video, photo, and digital camera to be used for promotional material and video distribution, and waive any rights of compensation or ownership thereto. I agree to allow my photo, video, or film likeness to be used by the event holders, producers, sponsors, organizers, and/or assigns.
____________________________ _______________________________
Print Participant’s Name Participant’s Signature
Age Date
____________________________ ____________________________
Name of Minor Participant Signature of Parent/Guardian
Age Date
Please mail this signed form to:
P.O. Box 2555
East Hampton, NY 11937
Or scan and e-mail signed form to: