Please read the following statements and place your initials in the provided answer area for this question for online registration signifying you have read this statement and are in complete agreement with the following statements. Release of Liability Schwitzgable Lake, LLC Participant User Agreement Release of Liability and Assumption of Risk Agreement I, (the “Participant”) do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with the recreational activities available at Schwitzgable Lake, LLC (“Schwitzgable Lake”) including but not limited to, use of the swimming, use of the zipline, use of off road motorized vehicles, use of fire arms, and other recreational activities (collectively, the “Activities”). Inherent risks and hazards related to the Activities include: 1. Risk of injury, including the potential for permanent disability and death. 2. Possible equipment failure and/or malfunction. 3. Outdoor risks associated with exposure to elements, excessive heat, hypothermia, impact of the body upon water, injection of water into body orifices, encountering objects either natural or man-‐made, and exposure to animals. 4. Participant’s own negligence and/or the negligence of others including, but not limited to, operator error. 5. Attack by or encounter with insects, reptiles, and/or animals. 6. Lack of available medical facilities nearby. I understand the above list of risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death. Release of Liability, Waiver of Claims and Indemnity Agreement In consideration of being permitted to participate in the Activities and other related activities at or around Schwitzgable Lake, I hereby acknowledge, agree, and appreciate that: 1. I understand the nature of the Activities in which I will engage, and that there are risks of injury and death associated with these Activities. I acknowledge and voluntarily assume the risks of illness, injury, death, and property damage associated with these Activities, whether or not described above, including those which may result from the negligent acts or omissions of other participants and/or Released Parties (defined below). 2. I, on behalf of my heirs, assigns, executors, estates, and personal representatives, hereby release, indemnify, and agree to defend and hold harmless Schwitzgable Lake and its owners, officers, managers, agents, employees, representatives, and volunteers (collectively, the “Released Parties”) from and against, and agree not to sue them for, any liability for causes of action that I, my minor child, estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, wrongful death, or any other damages, arising from or related to the Activities, whether caused by active or passive negligence of the Released Parties or otherwise, including claims and demands of any kind and nature whatsoever that may arise out of or relate in any way to my or my minor child’s participation in the Activities. The claims hereby released and indemnified include, but are not limited to, claims of other participants and of members of Participant’s family or associates. 3. I accept responsibility for payment of any expenses that may be incurred for any illness or injury that may result from my, or my minor child’s, participation in the Activities. 4. I am physically able to safely participate and complete the Activities. My participation in the Activities is purely voluntary, and I have elected to participate in spite of the risks. I am not pregnant nor do I have any medical conditions which may increase my risk of injury, illness, or death while participating in the Activities. I am not, nor will I be while participating in the Activities, under the influence of alcohol, illegal drugs, or impairing legal drugs. 5. By entering into this Agreement, I am not relying on any oral or written representation or statements made by any of the Released Parties, other than what is contained in this Agreement. I agree that the laws of the State of Ohio shall govern this Agreement and that the courts with jurisdiction in STARK County shall have exclusive jurisdiction in any dispute that may arise regarding this Agreement and/or the Activities. I have read, fully understand, and hereby agree to the terms of this Agreement. I acknowledge that this Agreement shall be effective and binding upon me, my heirs, assigns, executors, personal representatives, and estates. This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms shall be enforceable. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT. FOR PARTICIPANTS OF MINORITY AGE: This is to certify that I, as parent, guardian, or temporary guardian with legal responsibility for this Participant, do consent and agree not only to his/her release of the Released Parties to the fullest extent permitted by law, but also to release, protect, indemnify, defend, and hold harmless the Released Parties from any and all liabilities incident to my minor child’s involvement in the Activities. I have discussed the terms of the above Agreement with my child and am assured by my child that he or she understands the Agreement and has freely accepted its terms. I give my child permission to participate in the Activities. My signature below reflects my agreement to fully release, indemnify, defend, and hold harmless the Released Parties, as provided above in paragraph 2, from any claim which I may have, and, to the fullest extent permitted by law, to release such Released Parties on behalf of my child, for any claim my child may have. Parental Consent Form In the following statements, personnel refers to all authorized adult sponsors with the youth program, both paid staff and volunteers: I acknowledge that participation to fully participate in all activities which may include: self defense, archery, skeet, fishing, and firearm safety of an overnight camping trip sponsored by RiverTree, 854 Edison St NE (Rt. 619) Alliance OH 44601 described above involves risk to the Participant (and to Participant’s parents or guardians, if Participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage and financial damage. In consideration for the opportunity to participate in the activity described above (the “Activity”), the Participant (or parent/guardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the Activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the Activity or during transportation to and from the activity, as well as for any medical treatment rendered to the Participant that is authorized by the Sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to hereinafter as the “Activity Sponsor”). Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the Activity Sponsor for any injury arising directly or indirectly out of the described Activity or transportation to and from the Activity, whether such injury arises out of the negligence of the Activity Sponsor, the Participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the Participant (or parent/guardian) and the Activity Sponsor cannot agree upon such a process, the dispute will be submitted to a three-‐member arbitration panel for resolution pursuant to the rules of the American Arbitration Association. Emergency Authorization: I hereby give permission to the medical personnel attending to the treatment of my child to order x-‐rays, routine tests and treatment. In the event I cannot be reached in an emergency, I hereby give permission to the child named on this form. rev.5/16
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