WAIVER AND RELEASE OF LIABILITY

To save time on the day of your booking, please have each member of your party fill out and sign this waiver.

First name

Last name

Phone number

Email address

Address

Country/Region

Address

City

Zip / Postal code

Date of birth

Month

Day

Year

Party members under 18 years of age must have this form signed by a Parent/Guardian or they will not be permitted on the scheduled trip.

Make/Model of Vehicle

Color of Vehicle

Emergency contact name

Full name of person to contact in case of emergency

Emergency contact phone

Phone number of emergency contact

Date of activity

When will you be participating in this activity?

Time of Activity

In consideration of being allowed to participate in any way in TIPPA CANOE, L.L.C. operation, use of equipment, or related events and

activities, such as CANOEING, KAYAKING, TUBING and/or FLOATING; I fully understand and acknowledge, appreciate, and agree that outdoor recreational activities have:

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.

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF TIPPA CANOE, L.L.C. or others and assume full responsibility for my participation.

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 of participation, I will remove myself from participation and bring such to the attention of employees of TIPPA CANOE, L.L.C. immediately.

4. I for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS TIPPA CANOE, L.L.C.; their subsidiaries including but not limited to TIPPA ADVENTURES, their officers, officials, agents and or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used for the activity of TIPPCA CANOE, L.L.C., with respect to any and all injury, disability, death, loss or damage to person of property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF TIPPA CANOE, L.L.C. or OTHERWISE, to the fullest extent permitted by law.

I have read and understand the risks as stated above and agree to the terms set forth by Tippa Canoe and all State and Federal Agencies.

I agree to wear my Personal Flotation Device (P.F.D.) at all times while participating in CANOEING, KAYAKING, TUBING, and/or FLOATING activities.

I agree that I will not have any alcohol in shuttle vans/buses or in any rental equipment.

Abuse or abnormal damage to rental equipment will be charged to me at repair or replacement value.

I agree to return to the Tippa Canoe take-out ramp with all rental equipment by 6:00 p.m.

I acknowledge that I have read and understand the risks associated with this activity. I voluntarily assume all risks of injury, damage, or loss that may result from my participation.

I HAVE READ AND FULLY UNDERSTAND THE TERMS OF THE ABOVE WAIVER AND RELEASE. BY SIGNING THE BOTTOM OF THIS WAIVER I AGREE THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT. IT IS MY INTENTION TO EXCEPT AND RELIEVE TIPPA CANOE, L.L.C. FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I understand that this release and waiver is binding upon my heirs, executors, administrators, and assigns. I have read this agreement fully and understand its terms.

The venue of any dispute that may arise out of this agreement or otherwise between the parties to which TIPPA CANOE, LLC or its

agents is a party shall be either the McCurtain County, OK Justice Court or the County or State Supreme Court in McCurtain County.

All minors must be at least 6 years old and a minimum of 42 inches tall or they will not be allowed to float.

I will not be a Parent or Guardian of any minor on this trip.

I am the Parent or Guardian of a minor(s) on this trip.

WAIVER AND RELEASE OF LIABILITY

Address

Phone

Connect

We Accept