Give us a High Five!
2017 Camp Waiver
Private Camp Waiver
History of Dragon Boating
Staff Sign In
WAIVER AND RELEASE OF LIABILITY FORM
LAKE HERNANDO DRAGON BOAT FESTIVAL
I, the undersigned, in consideration for receiving permission to use the property and equipment of and/or participate in any event organized and/or run by Events in Motion or High Five Dragon Boat, LLC (“High Five”), and to enter the premises, waterways and grounds supervised or in any way controlled by Events in Motion, High Five or Citrus County Florida, and the receipt of said permission being hereby acknowledged, do hereby forever RELEASE any and all liability, discharge and agree not to sue Events in Motion, High Five or Citrus County Florida together with their respective agents, members, partners, trustees, representatives, officers, sponsors, licensors, servants, volunteers, or employees, hereinafter known as the releasees.
I agree to hold and save the releasees harmless and indemnify them from and against any and all liabilities, claims, injuries, losses, damages, expenses, demands, actions, and causes of action whatsoever of any kind or nature arising out of or related to any such loss, damage, or injuries, including death, that may be sustained by me, for whatever reason, while enroute to or from, or participating in or upon, the grounds supervised or controlled by High Five, whether such damages are the result of negligence, or for any other reason or cause.
I also agree to and discharge forthwith, on request of the releasees, each and every obligation or claim which will be made, assigned, or apportioned against the releasees by any party by virtue of any injury or damage caused to me.
I am duly aware of the risks and hazards inherent in the sport of dragon boating and related paddling sports, and upon entering the premises used for the purpose of launching, docking and storing equipment used in the sport of dragon boating and related paddling activities. In choosing to participate in dragon boating activities, knowing that conditions may be hazardous and dangerous, that obstructions may exist, and that high winds may exist and cause rough waters, I hereby voluntarily assume all risks of loss, damage or injury, including death, that may be sustained by me, or to any property, while in or upon said premises, or engaged in said activity. This Waiver includes injuries, damages, or loss occurring on the water, in the water, or in the air while participating in such activity.
In signing this Waiver, I acknowledge and represent that I have read and understand this release and agree to it voluntarily. I further understand that I am specifically waiving certain rights by this release to which I may have otherwise been entitled. I attest that I am at least 18 years of age and of sound mind. (If under 18 years of age, parent/guardian signature is required.)
Name of Participant
Date of Birth (DD/MM/YYYY)
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
AND I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF PADDLESPORTS AND RELATED ACTIVITIES AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE'S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.
Name of Parent/Guardian
Address of Parent/Guardian (if different from minor)
Phone Number of Parent/Guardian
Email of Parent/Guardian
Check this box to confirm your acceptance of the above terms of participation
High Five Dragon Boat, LLC
908 E 131st Avenue, Unit B, Tampa, FL 33612