Skyview Ranch Camp / Program Activity Waiver
All participants must read this release of liability form prior to signing and participating in program activities
Agreement to personally assume all risk and release of all claims for liability and waiver of right to sue based upon my understanding of these activities and their inherent risks.
I (full name) ________________________________ of (city and state) _________________________________
Having the date of birth (month) ________________ (day) ______, (year) _________ desire Skyview Ranch, a Ohio not for profit corporation, to permit me to participate in the following described activity. (Check the box or boxes that describe your activity.)
In order to participate in the above mentioned activities, I, the undersigned, agree and acknowledge that:
There is risk of injury, including a potential for permanent disability or death resulting from any participation in the above mentioned activities and or from the equipment involved in participation in such activities.
I freely assume all such risks, both known and unknown and assume full responsibility for my participation.
I will read and understand the rules of play, including all safety rules, and agree to fully comply with the rules and safety regulations during my participation.
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin hereby release and hold harmless Skyview Ranch, their officers, officials, agents and or employees, from any and all liability for injury, disability, death, loss or damage to personal property.
I acknowledge, understand and agree that I have read this release of liability and assume all risk associated with participating in the above mentioned activities and that I sign this release of liability voluntarily and without inducement.
I certify I am able to take a full and active part in the program at Skyview Ranch.
I further authorize Skyview Ranch to administer necessary medical treatment in case of accident or illness which occurs while a camper. I also realize that my picture or testimony may be used in promotion of the camp.
All program actives, and handling and use of program equipment must be supervised by
Skyview Ranch Staff.
Participants Name (Please Print): ______________________________________ Date of Birth: ____________________
Street Address: ____________________________________________________________________________________
City, State: ________________________________________________________ Zip Code: _______________________
Home Phone: ________________ Cell: ______________ Email: _____________________________________________
Emergency Contact: ______________________________ Relationship: _______________________________________
Emergency Contact Phone: ________________________ Insurance Carrier/ Number: ____________________________
Participant Signature: _______________________________________________ Date:____________________________
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Minor Aged Participants
All guests under the age of 18 at the time of participation must have a parent or guardian sign below.
I certify that I am the parent or guardian of ______________________ with legal responsibility for the above signed participant and agree to his/her release and agree to indemnify the above named companies and individuals from all liabilities resulting from his/her release and agree to indemnify the above named companies and individuals from all liabilities resulting from his/her participation in the above mentioned program activities for myself, my heirs, assigns, and next of kin.
Parent or Guardian Signature:
___________________________________________________________________________________ Date: _____________________
WAIVER: I, the undersigned participant (and my parent or guardian if I am younger than 18 years of age), intending to be legally bound, do hereby forever release and waive any and all rights, claims, and actions for damages that we, our heirs, executors, administrators, and assigns may have, or that may hereafter accrue against any and all persons, organizations, and other entities associated with the event, including, but not limited to Race Entry, USA Track and Field, sponsors, affiliates, volunteers, Rough and Rugged Race, and individual Rough and Rugged Race organizers, arising out of or in connection with my involvement before, during, or after the event.
I verify that I am physically fit and sufficiently trained to participate in this event and I assume the risks involved in this activity. I further attest that I will be mindful of traffic along the race course, and hold said sponsors and organizers blameless in any harm that may happen.
I also acknowledge understanding that the charge to my card will show up as Race Entry. I acknowledge that the online processing fees and charitable donations are non-refundable. I also acknowledge that any charitable donations will have 4.97% withheld from the donation to pay credit card and administrative costs.
Race Entry shall not be liable to you for any direct, indirect, special, incidental, consequential or exemplary damages including, but not limited to, loss of profits, goodwill, use, data or other intangible loses. Race Entry does not guarantee the completeness or accuracy of any information contained in, or provided in conjunction with the http://www.raceentry.com website. Race Entry is not responsible for any omissions or inaccuracies, or for the results obtained from this information.
Race Entry facilitates registration for various events, some of which allow participants under the age of thirteen (13). We require a submission of birth date for all registration entries. For children under the age of thirteen (13), parental or guardian consent is required.
You agree that the statutes and laws of the State of Utah, USA, will apply to all matters relating to this Agreement and Waiver. You irrevocably consent that exclusive jurisdiction for any dispute with Race Entry relating to this Agreement and Waiver resides in the courts of Utah, and you further agree and expressly consent to the exercise of personal jurisdiction in the courts of Utah in conjunction with any such dispute including any claim involving Race Entry .
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