Tag: document

Here’s a Neftaly Liability Waiver designed to be signed by participants, acknowledging the risks involved in extreme sports activities and releasing Neftaly from liability:

Neftaly Liability Waiver and Release of Liability

Participant Information:

1. Full Name:
   (First Name, Last Name)
2. Date of Birth:
   (MM/DD/YYYY)
3. Emergency Contact Name:
   (First Name, Last Name)
4. Emergency Contact Phone Number:
   (Mobile Number)

Acknowledgment of Risks:

I, the undersigned, acknowledge and understand that participating in extreme sports activities such as bungee jumping, zip-lining, and skydiving (collectively referred to as “Activities”) entails certain risks, including but not limited to:

• Injury or death caused by equipment malfunction or failure.
• Injury resulting from the inherent nature of the activities, such as falling, collision, or accidents.
• Injury caused by my own actions or inactions.
• Psychological and emotional challenges, including fear and stress, associated with participation.
• Risks associated with weather conditions, environmental hazards, and terrain.

I understand and voluntarily accept that these Activities involve inherent risks that may not be foreseeable, and that these risks cannot be entirely eliminated even with safety protocols and precautions in place. I further acknowledge that participating in these Activities may result in physical injury, emotional distress, and/or death.

Release of Liability:

In consideration of being permitted to participate in the Activities, I, for myself, my heirs, executors, administrators, and assigns, hereby release, waive, discharge, and covenant not to sue Neftaly, its employees, agents, officers, volunteers, sponsors, and affiliates (collectively, “Released Parties”) from any and all liability for injuries, losses, damages, or expenses of any kind arising from my participation in the Activities, even if caused by the negligence of the Released Parties.

I agree to indemnify and hold harmless the Released Parties from any and all claims, demands, actions, or suits arising from my participation in the Activities, including those caused by the negligence or fault of the Released Parties.

Medical Authorization and Responsibility:

I understand that if I am injured during my participation in the Activities, emergency medical treatment may be necessary. I authorize the Released Parties to seek medical treatment for me in the event of an emergency, and I agree to bear all costs associated with such treatment. I further acknowledge that I am responsible for my own health and safety and will notify the Neftaly staff of any pre-existing conditions that may affect my ability to safely participate in the Activities.

Health Declaration:

I affirm that I have provided accurate health information on the Neftaly Health and Safety Questionnaire and have consulted with a medical professional to confirm that I am fit to participate in these Activities. I also affirm that I have disclosed any medical conditions, allergies, or other health-related issues that may affect my ability to participate.

Voluntary Participation:

I acknowledge that my participation in the Activities is entirely voluntary. I have read this waiver in its entirety, understand its contents, and voluntarily agree to its terms. I further acknowledge that I have had the opportunity to ask questions about the risks involved in the Activities and that all my questions have been answered to my satisfaction.

Media Release:

I grant permission to Neftaly and its affiliates to use any photographs, video footage, and/or audio recordings taken during the Activities for promotional and marketing purposes, without compensation or further consent.

• Yes, I agree to the media release.
• No, I do not agree to the media release.

Participant Signature:

I, the undersigned, have carefully read this Liability Waiver and Release of Liability, and I understand its terms. I voluntarily accept the risks and agree to abide by the provisions outlined in this document.

Participant Signature: ___________________________
(Participant’s signature or typed name for consent)

Date: _____________________

For Participants Under 18 Years of Age:

If the participant is under 18 years of age, this waiver must be signed by a parent or guardian:

Parent/Guardian Name: _________________________
Parent/Guardian Signature: ______________________
Date: _____________________

This waiver is designed to ensure that participants are fully aware of the risks involved in extreme sports and legally release Neftaly from liability, while also acknowledging medical and safety responsibilities. It can be customized further as needed.