Blackwater Outdoor Adventures Parent/guardian Permission Slip printable pdf download

THE PERIOD OF :_________________, 20___ THROUGH ______________, 20_________.

BLACKWATER OUTDOOR ADVENTURES

PARENT/GUARDIAN PERMISSION SLIP

(This form to be used for minors only.)

I hereby grant permission for my child ______________________ to participate in whitewater rafting,

kayaking, canoeing, camping, biking or ______________________, and I hereby agree as follows:

I fully understand and acknowledge that: (a) risks and dangers exist in my child’s use of whitewater

rafting, canoeing, kayaking, camping, or _____________________________ activities; (b) my child’s

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 accident, or by the forces of nature or other causes. Risks and dangers may arise from

foreseeable or unforeseeable 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

substances, and will not carry, use, or consume these substances before or during her/his scheduled

activities. Any claims or disputes arising from my child’s participation in Blackwater Outdoor

Adventure’s whitewater rafting, canoeing, kayaking, camping, biking or _______________________,

activities or use of Blackwater Outdoor Adventure’s whitewater rafting, canoeing, kayaking, camping, or

_________________________ equipment shall be venued in the Tucker County Supreme Court or

the State of West Virginia.

My child is in good health and is at or above the minimum age stated in Blackwater Outdoor

Adventure’s 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 permit the use

of any photos, slides, films, or sketches of him/her taken during the day’s activities for publicity,

advertising, promotion or other commercial purposes. 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 BLACKWATER OUTDOOR

ADVENTURE’S whitewater rafting, canoeing, kayaking, camping, or __________________

ACTIVITIES, AND TO ASSUME AND ACCEPT ALL RISKS ASSOCIATED THEREWITH.

Group Name (if applicable) ______________________________________________________________

Parent’s Name (Print) __________________________ Signature _______________________________

City: _____________________________ State: _________________ Zip: ________________________

Child’s Name: ____________________________________________ Age: ___________________

Child’s Signature: ______________________________________________

Blackwater Outdoor Adventures RR 1 BOX 239 PARSONS, WV 26287

Blackwater Outdoor Adventures Parent/guardian Permission Slip