Waiver And Release Of Liability Form (Page 2 of 2) in pdf

all such fees and costs.

Should I or my successors assert any claim in contravention to this

agreement, I and my successors shall be liable for the expenses including legal fees and costs

incurred by White Rock Paddle Company in defending such claim.

5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while

participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I

have no medical or physical conditions which could interfere with my safety in this activity, or else I

am willing to assume - and bear the costs of --all risks that may be created, directly or indirectly, by

any such condition.

6. I understand that I may be the subject of the media publicity and promotion. In consideration for

being allowed to participate and other good and valuable consideration, I agree and authorize White

Rock Paddle Company to exhibit, with or without advertising sponsorship, as still photographs,

transparencies, motion pictures, television, video, verbal statements, voice, portrait, and pictures. I

authorize my name, voice, statements, and images may be used in such promotional materials and

website. I release White Rock Paddle Company, as well as any assignees, from any and all claims

for damages for libel, slander, invasion of privacy or any other claim based on use of the above-

described materials. I acknowledge that White Rock Paddle Company has no control over outside

media use of pictures and statements taken without permission and agree to hold White Rock Paddle

Company harmless for such use.

7. In the event that I file a lawsuit against White Rock Paddle Company, I agree to do so solely in the

state of Texas, and I further agree that the substantive law of that state shall apply in that action

without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is

found to be void or unenforceable, the remaining portions shall remain in full force and effect.

By signing this document, I acknowledge that if anyone is hurt or property is damaged during my

participation in this activity, I may be found by a court of law to have waived my right to maintain a

lawsuit against White Rock Paddle Company on the basis of any claim from which I have released

them herein. I have had sufficient opportunity to read this entire document. I have read and

understood it, and I agree to be bound by its terms.

Signature of Participant ______________________________

Print Name: _________________________________________

Address: ___________________________________________

Phone: ____________________________________________

Date: ______________________________________________

E-Mail: ____________________________________________

PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION

(Must be completed for participants under the age of 18)

I warrant that I am the parent and/or legal guardian of this minor. By my signature below, I

warrant that I have the right, power and authority to enter into this Agreement and I have completely

read and fully understand this Agreement and agree to be bound hereby, and to cause this minor to

comply therewith.

In consideration of_______________________ (print minor's name) ("Minor") being permitted by

White Rock Paddle Company to participate in its activities and to use its equipment and facilities, I

further agree to indemnify and hold harmless White Rock Paddle Company from any and all claims

which are brought by, or on behalf of Minor, and which are in any way connected with such use or

participation by Minor.

Parent or Guardian: ____________________________

Print Name: ____________________________Date: ________

Waiver And Release Of Liability Form Page 2

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