Dear Explorer Camp Families, Thank you for choosing Germantown Academy’s Explorer Camp. Please be sure to check the Day Camp website for each week’s daily schedule as the schedule changes every week. All waivers need to be signed and returned to Summer Programs by June 14th. We are having each family sign all the waivers even if they are not scheduled for that event because of changes in weather, group size, time adjustments etc. If waivers are not turned in, your child will not be able to join us on the day’s trip. Please check the website for important announcements and reminders such as arrival and pickup times. It is our intention to stay with the schedule but in the event of inclement weather, we will shift activities to accommodate the weather. While each day’s activities are different, there is some generic information that will help you to prepare for most activities. Each camper should have with them: • Sunscreen • Lunch and Snacks
• Insect Repellent • Two Water Bottles
• Backpack
• Hat & Rain Gear*
*A water-proof jacket is helpful when biking Note: A cooler will be available to store lunches and drinks. Pick-up time will vary each day. It will generally be around 4:30PM, but there will be some variability due to traffic, the speed of the rivers for tubing and rafting, and the amount of time required for each camper to complete an activity when biking. At the conclusion of each day’s activity, the director will pass a cell phone among the campers and ask that they contact their ride to alert them to the expected arrival time. On each day of camp please give your camper the phone number that you want used to contact you. In the event that you are unable to pick your child up at this time, extended day is available and you can arrange to pick up your child there. Regards, Daniel Stahl
Spring Mountain Adventures Canopy Tours CANOPY TOUR PARTICIPANT AGREEMENT, INCLUDING ASSUMPTION OF RISKS AND AGREEMENTS OF RELEASE AND INDEMNIFICATION AND AGREEMENT NOT TO SUE THIS IS A CONTRACT – READ IT! The parties to this contract are Spring Mountain Adventures, Inc. Third Generation Limited Partnership, Mountain Management, LLC.,Spring Mountain Adventures Canopy Tour, Grip It Adventures, their owners, officers, affiliates, employees and agents, the equipment manufacturers and distributors, and the owners of the property where Spring Mountain and the activity are located (hereinafter referred to collectively as “Spring Mountain”) and the persons signing below, including the participant in the activities of Spring Mountain Adventures Canopy Tours (Participant). _ This form must be read, understood, and signed by all Participants, adults and minors (persons under l8 years of age) AND by a parent or guardian (each referred to as “Parent”) of a minor Participant. Parent signs for himself or herself and on behalf of the minor child. No applicant may participate in a canopy tour unless these signatures are provided. Description of Activities The Spring Mountain Adventures Canopy Tour provides opportunities for environmental education and adventure recreation. The following elements are included in the tour: 1. Chair Lift – uphill transportation including getting on and off running lift. 2. Zip Lines. High cable traverses using safety harnesses and associated hardware. Riders zip through the upper canopy of the trees. 3. Rope Challenges. Walkways from the ground or high up, consisting of ropes or wood supported by cables. Participants wear safety harnesses attached to overhead steel cables. 4. Rapelling. Participants will be lowered or lower themselves while harnessed to the ground. 5. Climbing and Short Hiking. Participants will climb rocks and hike over boulders to view some of the tours natural elements. Tour groups will generally be limited to groups of up to 10 with up to 2 guides. The tours will be led or supervised by Spring Mountain Staff. All equipment will be fitted and checked by staff.
Medical Concerns Participants must be reasonably fit. They should be able to walk unassisted up stairs. They may be required upon occasion to pull themselves along a stretch of cable if they should lose momentum before reaching any given landing platform (guides may assist with this process). The canopy tour is designed for use by participants of at least average mobility and strength who are in reasonably good health. Obesity, high blood pressure, cardiac and coronary artery disease, pulmonary problems, arthritis, tendonitis, and other joint and musculo-skeletal problems and some psychological and psychiatric problems, may all increase the risks of the experience and cause the Participant to be a danger to himself or others. If you are uncertain as to whether or not you are fit enough to participate, you should consult your doctor before doing so. Inherent and Other Risks Serious injuries are uncommon in canopy tours, but the risk of injury certainly exists, by reason of falls, contact with other participants and fixed objects, moving about the grounds on which the activities are initiated and conducted, and otherwise. A number of risks are inherent to the activities. These are risks that cannot be eliminated without changing the essential nature and educational and other values of the activities. The emotional risks range from simple hurt feelings to panic and psychological trauma (fear of heights, for example). The physical risks range from small scrapes and bruises, to bites, stings, skin rashes, broken bones, sprains, neurological damage, and in extraordinary cases, even death. The property on which the tour is located includes uneven, rocky and wooded terrain, cliffs, ravines, springs, animal’s holes, and hold potentially harmful plants and animals, including snakes and other creatures which may bite or
sting. Injuries may be a natural consequence of the activity undertaken, a consequence of structural design or failure, as a result of environmental hazards (including terrain and weather), a result of errors of judgment or other negligence of staff or participants or otherwise; and may occur in spite of the reasonable efforts of staff to prevent them. In all such cases, these inherent risks, and other risks which may not be inherent, must be accepted by those who choose to participate. In consideration of participating in the Canopy Tour, which I and my group (if any) have contracted for with Spring Mountain, I the undersigned Participant, and/or the Parent of a minor Participant, agree as follows: 1. 2. 3.
I understand the nature of the activities that I will be engaging in as described above. I understand that there are risks of injury and death associated with these activities. I understand that certain of these risks, including those described above, are inherent in the activities and cannot be entirely reduced or eliminated from the activities. 4. I ACKNOWLEDGE AND VOLUNTARILY ASSUME THE RISKS OF ILLNESS, INJURY AND DEATH ASSOCIATED WITH THESE ACTIVITIES, INHERENT AND OTHERWISE, AND WHETHER OR NOT DESCRIBED ABOVE, INCLUDING THOSE WHICH MAY RESULT FROM THE NEGLIGENT OR OTHER ACTS OR OMISSIONS OF OTHER PARTICIPANTS OR SPRING MOUNTAIN. 5. I understand that Spring Mountain may refuse a canopy tour to persons Spring Mountain or their agents deem a hazard to themselves or others. Spring Mountain may alter its weight qualifications for participation under circumstances deemed appropriate by Spring Mountain. 6. I accept responsibility for any expenses that may be incurred for any illness or injury that may result from my participation in Provider’s programs, including the costs of evacuation, hospitalization, and medical treatment. 7. I HEREBY RELEASE, INDEMNIFY AND HOLD HARMLESS SPRING MOUNTAIN FROM, AND AGREE NOT TO SUE THEM FOR, ANY AND ALL LIABILITY FOR CLAIMS THAT MAY ARISE OUT OF OR RELATE IN ANY WAY TO MY ENROLLMENT OR PARTICIPATION IN SPRING MOUNTAINS PROGRAMS OR MY PRESCENCE ON ITS PROPERTY. THE CLAIMS HEREBY RELEASED AND INDEMNIFIED INCLUDE CLAIMS OF NEGLIGENCE OR ANY OTHER IMPROPER CONDUCT OF SPRING MOUNTAIN. 8. For myself, my family, heirs, representatives, and any other person claiming through me, I release, hold harmless and indemnify Spring Mountain for any sums which may be payable to anyone by reason of any injury or loss of life that I may sustain through my participation in Spring Mountains programs, and for all expenses associated with the defense of any such claims. I understand that this indemnification means that I accept responsibility for paying any costs, including attorneys’ fees, which may be due for claims made against Spring Mountain. 9. Spring Mountain reserves the right to use video or other photographic images of Participant for future marketing, educational or other purpose, and Participant (and Parent hereby consent to such use, without compensation. 10. Notwithstanding the foregoing, if I sue Spring Mountain, I agree that I will only sue it, whether on my own behalf or on behalf of a family member in the Court of Common Pleas of Montgomery County and further agree that any and all disputes which might arise between Spring Mountain and myself shall be litigated exclusively in said court. 11. I agree that should any part of this Agreement be judged invalid by a court with proper jurisdiction that all other parts not so judged shall nevertheless remain valid and in effect. 12. I have read, fully understand and hereby agree to the terms of this agreement, and am signing below intending to be legally bound thereby. Please provide the following information regarding the Participant: Signature____________________________________________________ Age________________________________ Printed Name ________________________________________________ Date _______________________________ Address _______________________________________________________________________________________ _ City _____________________________________State __________________________ Zip____________________ Telephone_________________________________________ Cell Phone____________________________________ Group Name (if any) ____________________________________________ Scheduled Date ____________________ Height ___________________ Weight (must be between 70-250 pounds) ___________________________________
Agreement by parent or Guardian of a Minor Child I am the parent or guardian of the minor child whose signature appears above. I have discussed the terms of the above Agreement with my child an am assured by my child that he or she understand the Agreement and has freely accepted its terms. I give my child permission to participate in the adventure challenge programs to be provided by Spring Mountain. My signature below reflects my agreement to fully release Spring Mountain, as provided above, from any claim which I may have, and to the fullest extent allowed by law, to release such persons on behalf of the child for any claim the child may have. I further agree to indemnify Spring Mountain, to the maximum extent allowed by law, for any claims of the child, or of any member of my or the child’s family, arising from the child’s enrollment or participation of the activities of the Provider. THESE AGREEMENTS OF RELEASE IN INDEMNITY INCLUDE CLAIMS OF NEGLIGENCE OR ANY OTHER IMPROPER CONDUCT. Signature ________________________________________ Date __________________________________________ Printed Name ____________________________________________________________________________________
Spring Mountain Adventures Rock Climbing Tower ROCK CLIMBING TOWER PARTICIPANT AGREEMENT, INCLUDING ASSUMPTION OF RISKS AND AGREEMENTS OF RELEASE AND INDEMNIFICATION AND AGREEMENT NOT TO SUE THIS IS A CONTRACT – READ IT! The parties to this contract are Spring Mountain.Adventures, Inc. Third Generation Limited Partnership, Mountain Management, LLC.,Spring Mountain Adventures Canopy Tour, their owners affiliates, employees and agents, the equipment manufacturers and distributors, and the owners of the property where Spring Mountain and the activity are located (hereinafter referred to collectively as “Spring Mountain”) and the persons signing below, including the participant in the activities of Spring Mountain Adventures Rock Climbing Tower (Participant). This form must be read, understood, and signed by all Participants, adults and minors (persons under l8 years of age) AND by a parent or guardian (each referred to as “Parent”) of a minor Participant. Parent signs for himself or herself and on behalf of the minor child. No applicant may participate in a canopy tour unless these signatures are provided.
Medical Concerns The rock climbing tower is designed for use by participants of at least average mobility and strength who are in reasonably good health. Obesity, high blood pressure, cardiac and coronary artery disease, pulmonary problems, arthritis, tendonitis, and other joint and musculo-skeletal problems and some psychological and psychiatric problems,, may l increase the risks of the experience and cause the Participant to be a danger to himself or others. If you are uncertain as to whether or not you are fit enough to participate, you should consult your doctor before doing so. Inherent and Other Risks While uncommon, the risk of injury certainly exists, by reason of falls, contact with other participants and fixed objects, moving about the grounds on which the activities are initiated and conducted, and otherwise. A number of risks are inherent to the activities. These are risks that cannot be eliminated without changing the essential nature and educational and other values of the activities. The emotional risks range from simple hurt feelings to panic and psychological trauma (fear of heights, for example). The physical risks range from small scrapes and bruises, to bites, stings, skin rashes, broken bones, sprains, neurological damage, and in extraordinary cases, even death. The property on which the Tower is located includes uneven, rocky and wooded terrain, cliffs, ravines, springs, animal’s holes, and hold potentially harmful plants and animals, including snakes and other creatures which may bite or sting. Injuries may be a natural consequence of the activity undertaken, a consequence of structural design or failure, as a result of environmental hazards (including terrain and weather), a result of errors of judgment or other negligence of belayers, staff or participants or otherwise; and may occur in spite of the reasonable efforts of staff to prevent them. In all such cases, these inherent risks, and other risks which may not be inherent, must be accepted by those who choose to participate. In consideration of using the Rock Climbing Tower, which I and my group (if any) have contracted for with Spring Mountain, I the undersigned Participant, and/or the Parent of a minor Participant, agree as follows: 13. I understand the nature of the activities that I will be engaging in. 14. I understand that there are risks of injury and death associated with these activities. 15. I understand that certain of these risks, including those described above, are inherent in the activities and cannot be entirely reduced or eliminated from the activities. 16. I ACKNOWLEDGE AND VOLUNTARILY ASSUME THE RISKS OF ILLNESS, INJURY AND DEATH ASSOCIATED WITH THESE ACTIVITIES, INHERENT AND OTHERWISE, AND WHETHER OR NOT DESCRIBED ABOVE, INCLUDING THOSE WHICH MAY RESULT FROM THE NEGLIGENT OR OTHER ACTS OR OMISSIONS OF OTHER PARTICIPANTS OR SPRING MOUNTAIN.
17. I understand that Spring Mountain may refuse climbing privileges to persons Spring Mountain or their agents deem a hazard to themselves or others. I accept responsibility for any expenses that may be incurred for any illness or injury that may result from my participation in Spring Mountains programs, including the costs of evacuation, hospitalization, and medical treatment. 18. I HEREBY RELEASE, INDEMNIFY AND HOLD HARMLESS SPRING MOUNTAIN FROM, AND AGREE NOT TO SUE THEM FOR, ANY AND ALL LIABILITY FOR CLAIMS THAT MAY ARRISE OUT OF OR RELATE IN ANY WAY TO MY ENROLLMENT OR PARTICIPATION IN SPRING MOUNTAINS PROGRAMS OR MY PRESCENCE ON ITS PROPERTY. THE CLAIMS HEREBY RELEASED AND INDEMNIFIED INCLUDE CLAIMS OF NEGLIGENCE OR ANY OTHER IMPROPER CONDUCT OF SPRING MOUNTAIN. 19. For myself, my family, heirs, representatives, and any other person claiming through me, I release, hold harmless and indemnify Spring Mountain for any sums which may be payable to anyone by reason of any injury or loss of life that I may sustain through my participation in Spring Mountains programs, and for all expenses associated with the defense of any such claims. I understand that this indemnification means that I accept responsibility for paying any costs, including attorneys’ fees, which may be due for claims made against Spring Mountain. 20. Spring Mountain reserves the right to use video or other photographic images of Participant for future marketing, educational or other purpose, and Participant (and Parent hereby consent to such use, without compensation. 21. Notwithstanding the foregoing, if I sue Spring Mountain, I agree that I will only sue it, whether on my own behalf or on behalf of a family member in the Court of Common Pleas of Montgomery County and further agree that any and all disputes which might arise between Spring Mountain and myself shall be litigated exclusively in said court. 22. I agree that should any part of this Agreement be judged invalid by a court with proper jurisdiction that all other parts not so judged shall nevertheless remain valid and in effect. 23. I have read, fully understand and hereby agree to the terms of this agreement, and am signing below intending to be legally bound thereby. Please provide the following information regarding the Participant: Signature____________________________________________________ Age________________________________ Printed Name ________________________________________________ Date _______________________________ Address _______________________________________________________________________________________ _ City _____________________________________State __________________________ Zip____________________ Telephone_________________________________________ Cell Phone____________________________________ Group Name (if any) ____________________________________________ Scheduled Date ____________________ Agreement by parent or Guardian of a Minor Child I am the parent or guardian of the minor child whose signature appears above. I have discussed the terms of the above Agreement with my child an am assured by my child that he or she understand the Agreement and has freely accepted its terms. I give my child permission to participate in the adventure challenge programs to be provided by Spring Mountain. My signature below reflects my agreement to fully release Spring Mountain, as provided above, from any claim which I may have, and to the fullest extent allowed by law, to release such persons on behalf of the child for any claim the child may have. I further agree to indemnify Spring Mountain, to the maximum extent allowed by law, for any claims of the child, or of any member of my or the child’s family, arising from the child’s enrollment or participation of the activities of the Provider. THESE AGREEMENTS OF RELEASE IN INDEMNITY INCLUDE CLAIMS OF NEGLIGENCE OR ANY OTHER IMPROPER CONDUCT. Signature ________________________________________ Date __________________________________________ Printed Name ____________________________________________________________________________________
In consideration of being allowed to participate in any way in the Bucks County River Country program, its related events and activities, I, _________________________, the undersigned, acknowledge, appreciate, and agree that: 1 The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2 I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3 I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately; and, 4 I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Bucks County River Country, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
x________________________________ Age: __ Date Signed: ________________ PARTICIPANT'S SIGNATURE FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's 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. x_________________________ ________________________ Date Signed: ________ PARENT/GUARDIAN'S SIGNATURE
(print name)
ŠCopyright2004 Bucks County River Country, Inc. Reproduction of this document in part or whole is prohibited under United States and International Copyright law, without the expressed written permission of Bucks County River Country, Inc. Walters Lane, Point Pleasant, PA 18950, USA.
ACKNOWLEDGMENT OF RISKS, ASSUMPTION OF RISK & RESPONSIBILITY, & RELEASE OF LIABILITY WARNING: There are significant elements of risk in any adventure, sport, activity or training associated with a “rock gym” or “climbing wall” or “rock climbing” (referred to herein as “activity”) and the use of any equipment. ACKNOWLEDGMENT OF RISKS: I recognize that there is an inherent risk of danger in this type of activity. These risks may result in serious injury or death and include but are not limited to 1) Falls; 2) Risk associated with crossing, climbing or down climbing; 3) Equipment failure; and 4) My physical coordination, sense of balance, decision making, and ability to follow or give directions either as a “climber” or “belayer.” I also acknowledge that certain foreseeable and unforeseeable events can contribute to the unpredictability of the activity; that personal property may be damaged or lost and that wearing appropriate clothing and footwear are basic safety precautions. EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY: In recognition of the inherent risks of which I and any minor children for which I am responsible, will engage in, I confirm that I am (we are) physically and mentally capable of participating in the activity and/or using equipment. I/we participate willingly and voluntarily and I assume full responsibility for personal injury, accidents or illness (including death), and any expenses as a result of my negligence or the negligence of any minor children for which I am responsible. I also assume responsibility for damage to or loss of personal property as the result of any accident that may occur. I also assume risk for accident or injury caused by the negligence of my belayer whether such negligence is comparative or contributory. I assume the risk(s) of personal injury, accidents and/or illness, including but not limited to sprains, torn muscles and/or ligaments, fractured or broken bones, eye damage, cuts, wounds, scrapes, abrasions, and/or spinal injuries, animal bite or attack, insect bite or allergic reaction, shock, paralysis, drowning, and/or death, and acknowledge that during the activity I/we may experience fatigue, chill and/or dizziness which may diminish my/our reaction time and increase the risk of an accident. COVENANT OF GOOD FAITH: I recognize that you, as a provider of services, will operate under a covenant of good faith and fair dealing, but that you may find it necessary to terminate an activity due to forces of nature, medical necessities, or problems in the group, and/or refuse or terminate the participation of any person you judge to be incapable of meeting the rigors or requirements of participating in the activity. I accept your right to take such actions for the safety of myself and/or other participants. I acknowledge that no guarantees have been made with the respect to climbing objectives. AUTHORIZATION: I hereby authorize any medical treatment deemed necessary in the event of any injury or illness I incur while participating in the activity. I either have appropriate insurance or, in its absence, agree to pay all costs of rescue and/or medical services as may be incurred on my/our behalf. RELEASE: In consideration of services or property provided, I, for myself and any minor children for which I am parent, legal guardian or otherwise responsible, any heirs, personal representatives or assigns, do hereby release: PRG Climbing Center, Philly Rock Corp., their principals, directors, officers, agents employees and volunteers, and each and every land owner, municipal and/or government agency upon whose property an activity is conducted, from all liability and waive any claim for damage arising from any cause whatsoever,(except that which is the result of gross negligence). I HAVE READ AND UNDERSTOOD THE FOREGOING ACKNOWLEDGMENT OF RISK, ASSUMPTION OF RISK AND RESPONSIBILITY, AND RELEASE OF LIABILITY. I UNDERSTAND THAT BY SIGNING THIS FORM I MAY BE WAIVING VALUABLE LEGAL RIGHTS. DO NOT DETACH BOTTOM PORTION FROM ABOVE DOCUMENT Participant’s Name (Printed) Home Phone E-Mail (Optional) Age __________________________________ ____________________________ ____________________________ _________ Date of Birth Street Address City State Zip _____ / _____ / _____ ___________________________________________ _____________________ In an emergency, please notify: Home Phone, Work Phone
(Optional)____________________________,________________________ (Full Name):__________________________________________ Do you have any medical conditions/restrictions: Yes No If yes, what are they: _____________________ ____________________________________________________________________________________ Signature of participant (if participant is over 18) ____________________________________________ Date: _____ / _____ / _____ Signature of parent/guardian (if participant is under 18) __________________________________________ Date: _____ / _____ / _____ PRG STAFF USE - DO NOT FILL OUT
[ ] Lesson Instructor ___________ [ ] Climb Only [ ] Test Pass [ ] Fail [ ] [ ] Group Date ____ / ____ / ____ NOTES: ______________________________________________________________________________ E- 520, N. Cicle Dr. | Oaks, PA 255 S. Mt. Airy Rd. | Valley Township, PA 877.822.ROPE
PRG CLIMBING CENTERS
PHILADELPHIA BIKE TOURS By Permaburn Society L.L.C.,
Bicycle & Moped Tours & Rentals Acceptance of Risk and Release of Liability & Indemnification Warning: All forms of Bicycling & Moped touring in areas with or without traffic are dangerous and hazardous. Alone or as part of a tour group, the safety and proper operating of the bicycle or vehicle is the sole responsibility of the operator. Accidents/falls from inconsistent street conditions as pot holes, sink holes, loose bricks, sand, gravel, leaves, damp conditions, train tracks, other motorist, pedestrians, animals, flat tires, any other distraction or irregularity of street surface, and potential bike or vehicle misuse and or malfunction require deliberate and conscious control of your bicycle or vehicle through proper use to ever changing variables and dangers of off road or City Traffic conditions. I hereby RELEASE AND DISCHARGE Permaburn Society L.L.C., Tour Guides (hired by myself), agents, and employees from any and all liability, claims, demands, or causes of action that I may have for injuries or damages arising out of my participation with Permaburn Society L.L.C. guided bicycle/moped tours and or rentals. I further understand that this release of liability applies to ANY Accident or occurrence of any kind which could occur as a result of using or riding on equipment, bicycles, and or mopeds furnished by Permaburn Society L.L.C. including if it’s agents and employees are negligent. I further acknowledge that a full disclosure of all inherent risk associated with this guided Tour or rental have been fully disclosed to me. This disclosure has been enforced through this signed statement and during the classroom or field training session required for ALL Guided Tours and rentals. This training included operation, maintenance, Best bicycle City routes of travel, known obstacles, and Test Ride to confirm users comfort and workings of the bicycle or Moped prior to starting any Tour or rental. I hereby knowingly and willingly ASSUME ALL RISK associated with this recreational activity. I understand and acknowledge that any bicycle/moped activity have inherent dangers that no amount of care, caution, instruction or expertise can eliminate. I hereby promise Not to sue whichever location rentals were obtained or Permaburn Society L.L.C., their owners, affiliates, employees, and agents, as I freely and voluntarily accept all risk of injury, death or property damage occurring thereon from the inherent risk as those listed above or those that can reasonably be inferred herefrom. **(Initial) X ________ I further agree to Release, Hold Harmless and indemnify Permaburn Society LLC. and any associated rental agents, affiliates, employees from any and all liability for personal injury including death and property damage from any alleged negligence in the operation, maintenance or design of the tours, bicycles or mopeds supplied. I further agree to INDEMNIFY AND HOLD THE REALEASED PARTIES HARMLESS from all claims, judgment and cost, including attorney fees, incurred in connection with any action for negligence brought as a result of my participating in this recreational activity. I further agree that I will only use the equipment in the manner specified and will be personally liable for any traffic/parking tickets and or damages to the equipment (bicycles, mopeds, wheels, locks, helmets, or other). I assume all responsibility for obeying ALL City, State, and Federal Traffic Laws and any damages to others including any and all property damages if incurred. **(Initial) X________
I have read this agreement assumption of risk and release of liability and fully understand its terms and contents. I FULLY UNDERSTAND I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, and sign it freely and voluntarily of my own free will.
Releasor: ___________________________________
Date: _____________
P r int N ame Signature: ____________________________ ______________________
Residence: Number and
Street:______________________ City, State, Zip Code FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liability incidents to my minor child’s 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. X_______________________________ _______________ ______________________________ Parent/Guardian Signature Date Emergency Phone Number(s)
PHILADELPHIA BIKE TOURS By Permaburn Society L.L.C.,
Bicycle & Moped Tours & Rentals Acknowledgement of Receiving Training for Bike/Moped Operation and Acceptance of Receiving said Bicycle/Moped in Good working Condition
I hereby acknowledge that Permaburn Society L.L.C., its Tour Guides (hired by myself), employees or managers, have issued me a proper working bicycle/moped in good working condition and fully described potential general and local hazards associated with this recreational activity. They have furthered explained the proper working operation of the bicycle or moped I am renting and have given me a road test to qualify my participation of this activity. I agree that I am comfortable in using the assigned bicycle/moped as a renal or as a tour and agree to INDEMNIFY AND HOLD THE REALEASED PARTIES HARMLESS from all claims, judgment and cost, including attorney fees, incurred in connection with any action for negligence brought as a result of my participating in this recreational activity.
Releasor: ___________________________________
Date: _____________
P r int N ame Signature: ____________________________
Bicycle #: _________________ Moped License Plate# :
______________ Acknowledgement of Receiving Proper Fitting Helmet for Bike/Moped Operation
I further acknowledge that a Proper Fitting Bicycle or DOT approved Moped Helmet was issued to me for
my assigned bicycle/moped and I was informed of the associated dangers of not wearing a helmet and by not doing so drastically increases my chance of major injury and possible fatality. Full disclosure of all inherent risk associated with this guided Tour or rental have been fully disclosed to me. This disclosure has been enforced through this signed statement and during the classroom or field training session required for ALL Guided Tours and rentals. This training included operation, maintenance, Best bicycle City routes of travel, known obstacles, and Test Ride to confirm users comfort and workings of the bicycle or Moped prior to starting any Tour or rental.
Signature: ____________________________
FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liability incidents to my minor child’s 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. X_______________________________ _______________ ______________________________ Parent/Guardian Signature Date Emergency Phone Number(s)
ACKNOWLEDGMENT OF RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY
In consideration of being permitted to be present at, compete and/or participate in the facilities and or activities conducted at and/or operated by Valley Forge Promotions LTD. The Arnold Group Inc. d/b/a Arnold’s Gokart and Family Fun Center, (herein called the “Center”) including but not limited to gokarting, arcade, laser tag and restaurant the address of which is 422 Business Center, V-2200 West Drive, Oaks, Pennsylvania 19456 (herein called the “Facility”), each of the undersigned, for him or herself, his or her personal representatives, eirs and next of kin, today and all future dates, intending to be legally bound: h 1. HEREBY ACKNOWLEDGES, AGREES AND REPRESENTS that he or she has or will immediately upon entering any part of the Area, and continuously thereafter, inspect the part of the Facility which he or she enters. He or she further agrees and warrants that if, at any time he or she is in or about any part of the Facility and he or she feels anything to be unsafe, he or she will immediately advise the owners or operators of the Center and will leave the Facility and/or refuse to participate further at the Center. 2. HEREBY RELEASES, WAIVES, DISCHARGES, AND COVENANTS NOT TO SUE, any and all of the following: Valley Forge Promotions d/b/a Arnold’s Gokart and Family Fun Center, its shareholders, directors, officers, agents, workmen and employees; the owners and/or operators of the Center and/or Facility; Center personnel; any person or persons in any part of the Facility and/or participant or participants; any inspectors, underwriters, consultants or others who give, or have given, recommendations, directions, or instructions, or engage, or have engaged in, risk evaluation or loss control activities regarding the Center and/or Facility; and each of them, their shareholders, directors, officers, agents, workmen and employees, (each and all of the foregoing herein called the “Releasees”) OF AND FROM ANY AND ALL LIABILITY TO THE UNDERSIGNED, his or her personal representatives, assigns, heirs and next of kin, FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIMS OR DEMANDS THEREFOR ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED arising out of or related to his or her presence, participation and or competition at the Center, whether caused by the negligence, gross negligence, recklessness and/or any other liability producing activity of the Releasees or otherwise. 3. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasees and each of them FROM ANY AND ALL LOSS, LIABILITY, DAMAGE, OR COST they may incur arising out of, or related to, his or her presence, participation and/or competition at the Center, whether caused by negligence, gross negligence and/or recklessness and/or any other liability producing conduct of Releasees or otherwise. 4. HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY AND ALL RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE arising out of or related to his or her presence, participation or competition at the Center, whether caused by negligence, gross negligence, recklessness and/or any other liability producing conduct of Releasees or otherwise. 5. HEREBY ACKNOWLEDGES THAT THE FACILITIES AND ACTIVITIES OF THE CENTER ARE VERY DANGEROUS AND INVOLVE THE RISK OF SERIOUS INJURY, DEATH AND/OR PROPERTY DAMAGE. Each of the undersigned also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.
6. HEREBY AGREES that this Acknowledgment of Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement extends to all acts of negligence and/or recklessness by the Releasees, INCLUDING NEGLIGENT AND/OR RECKLESS RESCUE OPERATIONS and is intended to be as broad and inclusive as is permitted by the laws of Pennsylvania, in which the Center is located; and that if any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 7. HEREBY ACKNOWLEDGES, AGREES AND CONFIRMS that the Center reserves the right to refuse to allow the undersigned to be present, participate and/or compete in any of the facilities and or activities of the Center, including, but not limited to, any facilities and/or activities whatsoever located and/or conducted at the Facility by the Releasees. 8. I represent that I am at least eighteen (18) years of age or in the alternative, that my parent or representative thereof, signs this document as a parent or guardian. I HAVE READ THE RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. Print First and Last Name Below Sign First and Last Name Below Date:
If Under 18:
Print Child’s First and Last Name Signature of Parent or Guardian Date: