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Aqua Park Waiver
LAKE STEPHENS WAIVER AND RELEASE OF LIABILITY FORM
Download Waiver Here of Fill Out Below
BY SIGNING BELOW I HEREBY ASSUME ALL OF THE RISK OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH RALEIGH COUNTY RECREATION AUTHORITY, including by the way of example and not limitation, any risk the may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, because of their possible liability without fault, or because of any circumstance or injury weather related.
I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised not to participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.
I acknowledge that this accident waiver and release of liability form will be used by the event holders, sponsors, and organizers of the activities in which i may participate, and that it may govern my actions and responsibilities at said activity.
In consideration of my application and permitting me to participate in this activity, I hereby take action of myself, my executors, administrators, heirs, next of kin, successors and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, from weather related circumstances or injuries, death disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS:
Raleigh County Recreation Authority, Lake Stephens Aqua Park and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of the participation in this activity, whether caused by the negligence or release or otherwise. I acknowledge that they are NOT responsible for the errors, omission, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity.
These risks are not only inherent to participants, but are also present volunteers. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. I understand while participating in this activity, I may be photographed.
The Accident Waiver And Release Of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
Participant’s Name:
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Additional Participants:
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Parent/Guardian Name (IF PATICIPANT IS UNDER 18)
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