Disclaimer

Contact

1. Legal Guardian or Parent Full Name, or your name. *

Each adult MUST fill out their own. One Adult can fill out for a few minors at once.

Address

Phone Number – Example: 000-000-0000 (PLEASE PUT DASHES) *

First Student

1. FIRST STUDENTS FULL NAME *

Add Minor under 18 (Click here)

1) “I” “me” includes (my child, children or legal guardian of minors under 18) under the age of (18). Acknowledge that: 2) Pertipants Knows How To Swim and To Maintain Buoyancy In Open Water, is in Good Health: swimming skills are those of at least a novice and I can maintain the head above water when the feet do not make contact with the bottom for periods of time. 3) Likewise, good physical and mental health, Are not under the influence of any drugs, alcohol, or other substances which may impair my swimming skills or my ability to take and follow instructions. Understand that the foregoing representations as to my physical condition are being relied upon by Learn to Northeast Surfing. 4) Acknowledge that surfing may be dangerous and accept, assume such risk: Aware that open water activities generally, and surfing specifically, involve inherent risks. May damage my belongings, get hurt, get injured, become ill, drown, or even die. Further acknowledge that I have voluntarily chosen to rent equipment or take surfing lessons, surfing clinic, from Northeast Surfing LLC, partners, staff, employees, owners, or if the individual taking such lessons, camps, or renting equipment is a minor, as the minor’s parent or legal guardian, voluntarily consented to such minor taking of such lessons, surfing camps. Acknowledge and willingly and voluntarily assume all risks and hazards in surfing and beach related activities in all phases of these activities from the training sessions until the conclusion of the class, lesson, camps or equipment rental period, including, but not limited to those involving, (1) loss of control of the surfboard, malfunction of the surfboard, falls from the surfboard, collision with other participants, equipment, other surfboards, rocks, and any other man made or natural obstacles, whether obvious or not. (2) judgment, decision making and conduct of the instructors; (3) submersion in water, drowning; (4) encounters with animals, marine life, plant life, rocks and insects; (5) exposure to outdoor ocean environment, bacteria or microbes, extreme temperatures, sun, and inclement weather, including travel by foot or vehicle in any way related to this activity; (6) assistance in lifting and /or carrying surfing equipment; (7) rescue-related injuries; and (8) unavailability of immediate and appropriate medical attention in case of injury. Understand and acknowledge that the above list is not meant to be complete or exhaustive, and that other unforeseen and unanticipated risks, known or unknown, may also exist and result in damage, injury, illness, disease, or death. 5) Waive My Right To Sue Northeast Surfing LLC, Staff, surfing instructors, partners, owners: In consideration for Northeast Surfing agreeing to provide me with equipment rental or surfing, clinics, instructions and/or allowing me to participate in this class, camps or lesson, I agree that I shall not make a claim or bring any action against, sue, or hold responsible, the City of HULL, MA, DCR, State of Massachustts, OR ANY CITY/BEACH WHERE THE LESSON ARE BEING PERFORMED, Northeast Surfing LLC, Staff, surfing instructors, partners, owners, officers, agents, employees, associates, representatives, (referred to collectively in this agreement as “Northeast Surfing LLC” Staff, surfing instructors, partners, owners,) or expect, require, or pursue them, to be held accountable for any damages. I voluntarily agree to release, discharge, and hold harmless Northeast Surfing LLC, Staff, surfing instructors, partners, owners, from and against any and all claims of liability, even those arising out of their negligence, fault, recklessness, or any other act or omission which causes me damages, illness, injury, disease, or death, of any nature in any way connected with my participation in this activity. 6) I also expressly agree to release and discharge Northeast Surfing LLC, or any of its staff, partners, owners, employees, from any act or omission, excluding acts of wanton or gross negligence, in rendering or failing to render any type of rescue, emergency or medical services. 7) Indemnity: I (my child, children or legal guardian of minor under 18) further agree, to hold harmless, defend, and indemnify Northeast Surfing LLC, Staff, surfing instructors, partners, owners, and the City IN WHICH THE LESSONS, CLINICS, ARE PERFORMED from all defense costs, including attorney’s fees incurred in connection with any claims arising from the activities anticipated herein, including but not limited to those for bodily injury, wrongful death, or property damage, whether caused by or sustained by any minor under 18 years of age on whose behalf I am signing, or which I may have caused to spectators or other third parties, whether negligent or not, in the course of my participation in this activity. 8) Permission to Obtain Medical Assistance: In the event of any injury, illness, emergency, accident or other harm sustained by me (or by the minor on whose behalf I am signing this document), Hereby give Northeast Surfing LLC, Staff, surfing instructors, partners, owners, any of its staff, or CERTIFIED LIFEGUARDS (unless someone is present that legally represents myself, permission to obtain Medical Assistance, in which event I hereby make the same releases and waivers in Northeast Surfing’s favor as I have otherwise made in this agreement in connection with any such medical assistance sought or not sought. In addition, the expenses for any such medical emergency shall be my (my child, children or legal guardian of minor under 18) sole responsibility and not that of Northeast Surfing LLC, Staff, surfing instructors, partners, and owners. I agree to receive medical attention by trained medical personnel in the event I am not able to communicate with responding medical emergency personnel. 9) Promotional Use of Images – Videos: I hereby agree that Northeast Surfing may use film or photographic records of this surfing class, clinics, or lessons for its promotional and/or commercial purposes without compensation to me. Any images, videos, obtained for commercial use will never include personal information, and Northeast Surfing LLC does not share client’s personal information. 10) I hereby expressly recognize this Release of Liability, Waiver of Legal Rights, and Assumption of Risk is a contract pursuant to which I have released any and all claims against the Released Parties resulting from my participation in Northeast Surfing LLC Activities including any claims by the negligence of the Released Parties. *

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Disclaimer

Contact

First Student

Add Minor under 18 (Click here)

Add Minor under 18 (Click here)

Add Minor under 18 (Click here)

Add Minor under 18 (Click here)

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