Waiver

WAIVER, GENERAL RELEASE AND INDEMNITY AGREEMENT
Bundeena Kayak Hire

Last Name

First Name

MI

Telephone

Street Address

City

State

Post Code

Emergency Contact/Chaperone

Emergency Telephone

Birth Date

Age

Email Address:

 

Parent / Guardian

This Waiver and General Release is for the above mentioned customer participant with regards to any and allwater craft (kayak or paddle board) hired by Bundeena Kayak Hire where ever the craft is hired from or whereever the pursuing use of the craft takes place.

In consideration of being given the opportunity to hire this craft for water Activities, I, for myself or my child, my personal representative, assigns, heirs and next of kin:

For the consideration stated above, I further agree that in the event that I ( the adult participant ) or my child ( the child participant / minor ) should make any claims against the Releases for damages arising out of the above named program, activity, or sport, I will personally INDEMNIFY, DEFEND AND HOLD HARMLESS Bundeena Kayak Hire And any of its officers/directors, agents, employees, representatives, sponsors, co-sponsors, affiliates, successors, and assigns against any and all loss and damage occasioned hereby, including attorney’s fees.

I have read and understand this agreement and have willingly placed my signature below as evidence of my acceptance of all the conditions contained herein.

Signatures:

Participant ___________________________________________ Date _______________ (If participant is not a minor)

Parent or Guardian _____________________________ Date_________________________

 

EMERGENCY PROCEDURES:

In case of an emergency call Bundeena Kayak Hire: 0425 210 270

Signatures:

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