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Fillable Printable General Release of Liability Form-NOC Universal Waiver - Final

Fillable Printable General Release of Liability Form-NOC Universal Waiver - Final

General Release of Liability Form-NOC Universal Waiver - Final

General Release of Liability Form-NOC Universal Waiver - Final

01674019.2
For NO C use only
Activity Date :
Rsv Party Name:
Activity Time :
Rsv #:
Activity Type:
# in Party:
RELEASE OF LIABILITY/LIABILITY WAIVER FORM
FULL LEGAL NAME of PARTICIPANT: _________________________________________________________________________
ADDRESS: _________________________________________________________________________________________________
CITY, STATE, ZIP: _________________________________________ PHONE: __________________________________________
EMAIL: _______________________________________________________________
PRINT Full Name of Emergency Contact: ______________________________
Relationship of emergency contact: ____________________________ Phone(s) of Contact Person: __________________________
Activity Participation Acknowledgement
I, the undersigned, hereby acknowledge that I am participating in an activity for which Nantahala O utdoor C ente r, L L C, a Georgia limited
liability company or one of its subsidiaries (individually and FROOHFWLYHO\³12&´ is furnishing equipment or services and which requires
physical exercise, including, without limitation, rafting, kayaking, swimming, stand-up paddle boarding, rock climbing, hiking, rappelling,
zip-lining, ropes course navigating, RUF\FOLQJWKH³$FWLYLW\´. By signing this waiver, I certify that I am in good health and physical
condition and do not suffer from any disability which would prevent my participation in the Activity. I agree to abide by any decision of any
NOC employees, organizers, volunteers, directors, representatives, agents, and officers FROOHFWLYHO\WKH³12&3DUWLHV´regarding my ability
to safely participate in the Activity. I fully understand that I may injure myself as a result of my participation in the Activity and that certain
injuries may result in death or permanent physical disability. I also acknowledge and agree that my participating in any Activity may be
terminated immediately if any of the NOC Parties believe, in their sole discretion that I am unable to complete the Activity for any reason or
that I am under the influence of alcohol or drugs.
Risk Acknowledgement, Indemnity and Release
In consideration of my participation in the Activity, I hereby assume all risks, known and unknown, associated with participation in the
Activity including, but not limited to, any injuries resulting from falls, contact with other participants, the conditions of Activity sites, bodily
injuries and death. To the fullest extent permitted by law, I hereby agree to indemnify, hold harmless and defend the NOC Parties, as well as,
where applicable, the Tennessee Valley Authority, Ocoee River Outfitters Association, the state of Tennessee, the U.S. Forest Service, the
United States of America and other any federal or state governmental agencies or other entities who may have an interest in any river, lake,
RURWKHUUHDOSURSHUW\RUZDWHUZD\RQZKLFKWKH$FWLYLW\WDNHVSODFHLQGLYLGXDOO\DQGFROOHFWLYHO\WKH³Indemnified 3DUWLHV´ from and
against any and all claims, losses, damages, expenses and other liabilities (including, but not limited to, court costs and aWWRUQH\¶VIHHV
arising out of or resulting in whole or in part from my participation in the Activity. I for myself and anyone entitled to act on my behalf,
including, but not limited to my heirs and successors, hereby RELEASE, WAIVE AND FOREVER DISCHARGE the Indemnified Parties
from any and all claims, losses, damages, expenses and other liabilities of any kind arising out of my participation in the Activity even if such
claims, losses, damages, expenses and other liabilities arise out of negligence or carelessness on the part of any or all of the of the
Indemnified Parties.
Media Release
I hereby grant and convey to the NOC Parties all right, title and interest I may have in any and all photographs, motion pictures, video
recordings, and any other recordings made during or about the Activity, and the NOC Parties shall have the right to exploit such recordings
throughout the universe, an unlimited number of times, in perpetuity by any and all means and media, now known or hereafter invented.
Medical Emergencies
I hereby give permission to the NOC Parties to contact emergency services for help, whether or not the NOC Parties have contacted my
emergency contact, and give permission to a licensed physician or other licensed medical provider to provide proper treatment, including but
not limited to hospitalization, injection, anesthesia and/or surgery. I hereby RELEASE, WAIVE AND FOREVER DISCHARGE the NOC
Parties from any and all claims, liabilities, causes of action, damages, demands, judgments, executions, liens and costs whatsoever in law or
equity, including, without limitation, liability for death or bodily injuries to any person or damage to any property resulting from any (i)
claims made against medical providers of emergency services under this authorization, or (ii) against the NOC Parties for obtaining
emergency medical services for me pursuant to this authorization and waiver.
______________
Date Your Signature
If you are under the age of 18, your parent or guardian must execute this form on your behalf.
______________
Date <RXU3DUHQW¶VRU*XDUGLDQ¶VSignature
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