ACKNOWLEDGMENT AND ASSUMPTION OF RISKS,
LIABILITY RELEASE AND INDEMNITY AGREEMENT
The success of the program in which you are (or your son, daughter or ward is) participating
depends to a large extent on good communication among all parties involved, including parents
and guardians of minor participants. It is important to the Hurricane Island Foundation
(“HIF”) that you understand the nature of its programs and that you are informed regarding
risks, limitations of liability, emergency medical treatment, and other legal issues. Your
signature below reflects certain understandings and agreements. The parent or legal guardian
makes these agreements for himself or herself individually, and on behalf of the minor
participant. “I” and other first person references, below, are to the minor or adult participant
and to the parent or legal guardian of a minor unless otherwise indicated.
In consideration of being allowed to participate in an HIF program or on property leased by HIF,
I understand and agree as follows:
I am aware that certain risks and dangers may be encountered during the program in which I (or
my child or ward) will be participating. Activities will depend on the program and may include
(but are not limited to): conducting research and other activities on a remote, forested island
formerly used as a quarry, and along the shoreline and within the intertidal zone; working with
photovoltaic panels, wind generators, or wiring batteries; running; hiking on or maintaining trails
which may include use of hand tools and light duty power tools; participating in low ropes
course elements (activities on ropes or other devices potentially suspended a few feet off the
ground for team building exercises); rock climbing and rappelling; swimming; travel in small
sailing vessels, row boats, kayaks, small boats, and in motor vessels over exposed water; visiting
other small islands: medical training exercises; and cooking, camping, and living in rustic
accommodations.
The inherent risks, hazards, and dangers of these and other activities include but are not limited
to: slipping, falling, or being struck by objects or persons, potentially from great heights; falling
into or being submerged in extremely cold water; drowning; electric shock; accidents or illnesses
in a remote area without medical facilities or where access to medical care could be significantly
delayed; the unpredictable forces of nature; tick borne illnesses; exposure to marine life or
poisonous plants; and instructor misjudgment. These risks and others may result in the loss of
property, personal injury, including emotional trauma, illness, and in extreme cases permanent
disability or even death. I understand and acknowledge the inherent and other risks of my
(or my child’s) program and that there may be other unknown or unanticipated risks. I
wish to participate (or have my child participate) in spite of the risks. I agree to assume all the
risks of participating in activities or being present on HIF leased property whether those
risks are inherent or not and whether listed above or not.
I agree, to the fullest extent allowed by law as follows:
1)
To release HIF, its agents, representatives, officers, directors, employees,
volunteers, independent contractors and others acting under their direction and control
and the owners of properties on which HIF activities may take place (collectively “the
Released Parties”), from any right, claim or cause of action which I, or the minor
Version June 2013
participant, may have for any injury, illness, emotional trauma, wrongful death, property
damage, product liability (including strict liability), arising from my activities or presence
on HIF leased premises or arising from the use of any equipment or facilities, and which is
alleged under breach of warranty or contract, premises liability, the Released Parties’
negligence, or any other legal theory. However, I do not waive any claims for gross negligence
or intentional wrongs of the Release Parties.
2)
To defend, hold harmless and indemnify (meaning to pay or reimburse for any
expense including attorneys’ fees and costs) the Released Parties from any liability, loss
damages or expenses resulting from a loss caused by or suffered by me (or the minor
student) including claims brought by a fellow participant, rescuer, me, a member of my, or
the minor participant’s family, or any other person asserting a loss in any way related to
my (or the child’s) participation in the activities or my presence on lands leased by HIF.
This indemnity provision applies to claims that the Released Parties were negligent but does not
include claims of gross negligence or intentionally wrongful conduct.
I am aware that the Hurricane Island Foundation is a non-profit charitable corporation with its
registered office in Portland, Maine. All matters relating to or arising out of or involving in any
way my (or my son’s, daughter’s or ward’s) relationship with the HIF shall be governed by the
substantive laws of the State of Maine, and any mediation or suit shall be filed only in the State
of Maine. If a dispute with HIF cannot be amicably resolved, I agree to submit the matter to
mediation before a mutually agreeable mediator recognized by Maine courts, in an effort to
avoid suit.
HIF may use my (or the minor student’s) name, photo, video, or other image in promotional
materials and press releases without further notification or compensation.
HIF may use the services of private contractors for certain tasks, including transportation to the
island. HIF is not responsible for the acts or omissions of such independent contractors.
If any part of this agreement is found to be invalid, the remainder of the agreement shall be in
full force and effect.
I have carefully read this document and understand I am surrendering legal rights. I agree
the terms of this agreement are binding on me, my family, heirs, executors, and
administrators. An electronic copy of my signature is as valid as an original.
__________________________________________________________
Participant Signature
DATE
A parent or guardian’s signature is required if participant is under 18 (or if participant is a
resident of Alabama and under the age of 19) (or if participant is a resident of Mississippi and
under the age of 21). I certify that I have legal authority to act on behalf of the minor child.
__________________________________________________________
Parent or Guardian
DATE
____________________________________________________
Printed Name of Participant (AND Parent or Guardian and Relationship)
Version June 2013