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PRINT THIS FORM, FILL OUT FOR
CHILD TO PRESENT TO SYLVANIA OUTFITTERS
PARENT/GUARDIAN PERMISSION FORM
(This form to be used for minors only)
I hereby grant permission for my child_____to
participate in whitewater rafting, kayaking, camping, or canoeing at Sylvania
Outfitters on and I hereby agree as follows:
I fully understand and acknowledge that: (a)
risks and dangers exist in my childs use of rafting, kayaking, camping, or canoeing
equipment and my childs participation in rafting, kayaking, camping, or canoeing
activities; (b) my childs participation in such activities and/or use of such
equipment may result in injury or illness or death or damage to personal property; (c)
these risks and dangers may be caused by other participants, or by accidents, or by the
forces of nature or other causes. Risks and dangers may arise from foreseeable causes
including, but not limited to, selection of trail or river route, water level, weather
conditions, risks of falling out of a raft, kayak, or canoe, and such other risks, hazards
and dangers that are integral to recreational activities that take place in a wilderness,
outdoor or recreational environment; and (d) I hereby accept and assume these risks and
dangers.
I have been advised that my child must wear an
approved personal flotation device at all times while on the water. I affirm that my child
will not be under the influence of alcohol or controlled substance, and will not carry,
use, or consume these substances before or during her/his scheduled activities. Any claims
or dispute arising from my childs participation in Sylvania Outfitters
activities or use of Sylvania Outfitters equipment shall be venued in the Gogebic
County Supreme Court of the State of Michigan.
My child is in good health and is at or above
the minimum age stated in Sylvania Outfitters advertising for each activity in which
he/she will participate. I understand that strenuous physical exertion may be required and
my child has no known physical disabilities or health problems, which will present any
risk to his/her participation in the activities. I release and agree to indemnify and hold
harmless the Releasees from any and all liabilities incident to my minor childs
involvement or participation in these programs as provided above. EVEN IF ARISING FROM THE
NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law. I permit the use of
any photos, slides, films, or sketches of him/her taken during the days activities
for publicity, advertising, promotion or other commercial purpose. The above agreement
shall be binding on my heirs, successors, assigns, administrators and executors.
I HAVE READ THE ABOVE AND BY SIGNING IT AGREE.
IT IS MY INTENTION TO GRANT PERMISSION FOR MY CHILD TO PARTICIPATE IN SYLVANIA
OUTFITTERS RAFTING, KAYAKING, CAMPING, OR CANOEING ACTIVITIES, AND TO ASSUME AND
ACCEPT ALL RISK ASSOCIATED THEREWITH.
Group Name (if
applicable)____________________________
Parents
Name________________________Signature_____________________________________
Street and Apt. Address:
City:________________________________State:_____________________
Zip:_______________
Childs
Name:_________________________Age:______________ Trip Date:__________________
Childs
Signature:_________________________________
DO NOT LOSE! PLEASE GIVE
COMPLETED FORM TO YOUR GROUP LEADER