Paddle Board Trip Permission Form
Your child has been invited to attend a paddleboard outing chaperoned by __________________________
ON date: _______________________________ FROM time: _____________________________________
at: Three Oaks Recreation Area, 5517 Northwest Hwy, Crystal Lake IL
provided by: Alpine Accessories, 9219 S IL Route 31, Lake in the Hills IL
- I acknowledge that Stand Up Paddleboarding (Also referred to as “The Activity”) is hazardous and involves a great risk of physical activity. I assume all risks associated with The Activity including, but not limited to, change of weather conditions, hidden underwater obstacles, changing and unpredictable currents, drowning, exposure, riptides, undertows and sea life. I acknowledge that Stand Up Paddleboarding may involve serious personal injury or even death. I hereby recognize and assume those risks.
In consideration of the rental or demo of Stand Up Paddleboard, surfboard or body board from ALPINE ACCESSORIES (“The Shop”), I agree to release and hold harmless the Shop, it subsidiaries and affiliates, their respective agents, directors, officers, owners, contractors and employees (collectively “the Released Parties”) from any and all claims I might have as a results of the Activity, including those claims based on negligence or breach of warranty. Additionally, I agree to indemnify the Released Parties for any and all claims whatsoever brought by a third party for any damage which I may cause or which any other person may cause while engaged in the Activity.
- I agree to return it in the same condition as I receive it, normal wear and tear accepted. I understand and agree that I am responsible for the board and any other equipment provided.
- I am signing this liability release on behalf of a minor between 12 and less than 18 years of age (“the child”), I represent that I am parent and/or legal guardian of the child. I accept responsibility for all the child’s medical expenses incurred in connection with the Activity; I agree to indemnify the Released Parties for any and all medical claims brought by the child; and I agree to indemnify the Released Parties for any and all medical claims brought by a third party arising in connection with the child.
- In exchange for the shop allowing me to rent or demo the after mentioned equipment, I contractually agree that any and all disputes between myself and the Shop arising from my use of this equipment OR my participation in the Activity, INCLUDING any claims for personal injury and/or death will be GOVERNED BY THE LAWS OF THE STATE OF IL and EXCLUSIVE JURISDICTION thereof will be in the state court residing in the country where the alleged tort occurred or federal court of the state of IL.
- I agree that if any portion of this release is found invalid or unenforceable, the remaining provisions will be fully enforceable to the fullest extent allowed by law.
This agreement is binding on my estate, heirs, administrators and assigns.
I HAVE CAREFULLY READ THE FOREGOING LIABILITY RELEASE, UNDERSTAND ITS CONTENTS AND SIGN IT WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE.
I give permission for my child _______________________________________________________________
To attend the paddle board trip to Three Oaks Recreation Area, 5517 Northwest Hwy, Crystal Lake IL
In case of an emergency, I give permission for my child to receive medical treatment. In case of such an emergency, please contact:
Name _____________________________________________________ Phone________________________________
Parent / Guardian Signature _______________________________ Date _________________________________