Partner Program Waiver = required field THE MOUNTAINEERS ACKNOWLEDGEMENT OF RISKS AND WAIVER AND RELEASE OF LIABILITY Youth & Adult Partnership Program Participants I hereby state that I approve of my or my child’s participation in courses and/or activities offered by The Mountaineers, a non-profit corporation. I recognize any outdoor activity may involve certain risks, including but not limited to the hazards of traveling in mountainous terrain, accidents or illness in remote places, extreme heat, extreme cold, rain, snow, falling rock, hazardous plants, insects and animals, force of nature, and the actions of participants and other persons. I further understand and agree that without some program providing protection of its assets and its leaders, The Mountaineers would not be able to offer its courses and activities. IN CONSIDERATION FOR ME OR MY CHILD BEING PERMITTED TO PARTICIPATE IN MOUNTAINEERS ACTIVITIES, I HAVE READ OR HAVE HAD READ TO ME THE RISKS OF ACTIVITIES WITH THE MOUNTAINEERS. I VOLUNTARILY ACCEPT THE RISKS INVOLVED. I AM AWARE THAT I OR MY CHILD WILL HAVE THE OPPORTUNITY TO PARTICIPATE IN MOUNTAINEERS ACTIVITIES INVOLVING A DEGREE OF RISK. I CHOOSE TO PARTICIPATE WITH THIS KNOWLEDGE, AND/OR I APPROVE OF MY CHILD’S PARTICIPATION, IN THESE ACTIVITIES. I AGREE TO RELEASE ANY CLAIMS THAT I MIGHT HAVE AS AN ADULT FOR ANY LOSS, INJURY OR DAMAGE RELATED TO MY OR MY CHILD’S PARTICIPATION, INCLUDING CLAIMS BASED ON NEGLIGENCE. I FURTHER AGREE TO HOLD HARMLESS AND INDEMNIFY THE MOUNTAINEERS FOR ANY CLAIMS BROUGHT BY OR ON BEHALF OF MY CHILD. I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO PROVIDE FOR MY OR MY CHILD’S ACCIDENT AND HEALTH COVERAGE WHILE PARTICIPATING IN ANY MOUNTAINEERS ACTIVITY. THE MOUNTAINEERS DOES NOT PROVIDE ANY ACCIDENT OR HEALTH COVERAGE FOR ITS PARTICIPANTS. I give permission for The Mountaineers to use, without limitation or obligation, photographs or other media that may identify or include the image or voice of me or my child to promote or interpret Mountaineers programs for any business purpose, including media coverage. I waive all claims for any compensation for such use. I HAVE READ OR HAVE HAD READ TO ME, AND I UNDERSTAND AND AGREE TO THE ABOVE STATEMENTS. I UNDERSTAND THAT THIS FORM MAY NOT BE ALTERED AND THAT I OR MY CHILD MAY NOT PARTICIPATE WITHOUT THIS FORM SIGNED. I ACKNOWLEDGE THAT I HAVE SIGNED THIS OF MY OWN FREE WILL, THAT THIS DOCUMENT MAY AFFECT MY LEGAL RIGHTS, AND THAT MY OR MY CHILD’S PARTICIPATION IN MOUNTAINEERS ACTIVITIES IS PURELY VOLUNTARY. Your E-Mail Address Partner Program Please name the partner program the participant is enrolled in. Start Date of Program Participant Full Name Participant Signature By checking this box, I’m confirming my signature on this form. Participant Date of Signature FOR MINORS (Under 18 Years Old) Parent/Guardian Full Name Parent/Guardian Signature By checking this box, I’m confirming my signature on this form. Parent/Guardian Date of Signature
Partner Program Waiver = required field THE MOUNTAINEERS ACKNOWLEDGEMENT OF RISKS AND WAIVER AND RELEASE OF LIABILITY Youth & Adult Partnership Program Participants I hereby state that I approve of my or my child’s participation in courses and/or activities offered by The Mountaineers, a non-profit corporation. I recognize any outdoor activity may involve certain risks, including but not limited to the hazards of traveling in mountainous terrain, accidents or illness in remote places, extreme heat, extreme cold, rain, snow, falling rock, hazardous plants, insects and animals, force of nature, and the actions of participants and other persons. I further understand and agree that without some program providing protection of its assets and its leaders, The Mountaineers would not be able to offer its courses and activities. IN CONSIDERATION FOR ME OR MY CHILD BEING PERMITTED TO PARTICIPATE IN MOUNTAINEERS ACTIVITIES, I HAVE READ OR HAVE HAD READ TO ME THE RISKS OF ACTIVITIES WITH THE MOUNTAINEERS. I VOLUNTARILY ACCEPT THE RISKS INVOLVED. I AM AWARE THAT I OR MY CHILD WILL HAVE THE OPPORTUNITY TO PARTICIPATE IN MOUNTAINEERS ACTIVITIES INVOLVING A DEGREE OF RISK. I CHOOSE TO PARTICIPATE WITH THIS KNOWLEDGE, AND/OR I APPROVE OF MY CHILD’S PARTICIPATION, IN THESE ACTIVITIES. I AGREE TO RELEASE ANY CLAIMS THAT I MIGHT HAVE AS AN ADULT FOR ANY LOSS, INJURY OR DAMAGE RELATED TO MY OR MY CHILD’S PARTICIPATION, INCLUDING CLAIMS BASED ON NEGLIGENCE. I FURTHER AGREE TO HOLD HARMLESS AND INDEMNIFY THE MOUNTAINEERS FOR ANY CLAIMS BROUGHT BY OR ON BEHALF OF MY CHILD. I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO PROVIDE FOR MY OR MY CHILD’S ACCIDENT AND HEALTH COVERAGE WHILE PARTICIPATING IN ANY MOUNTAINEERS ACTIVITY. THE MOUNTAINEERS DOES NOT PROVIDE ANY ACCIDENT OR HEALTH COVERAGE FOR ITS PARTICIPANTS. I give permission for The Mountaineers to use, without limitation or obligation, photographs or other media that may identify or include the image or voice of me or my child to promote or interpret Mountaineers programs for any business purpose, including media coverage. I waive all claims for any compensation for such use. I HAVE READ OR HAVE HAD READ TO ME, AND I UNDERSTAND AND AGREE TO THE ABOVE STATEMENTS. I UNDERSTAND THAT THIS FORM MAY NOT BE ALTERED AND THAT I OR MY CHILD MAY NOT PARTICIPATE WITHOUT THIS FORM SIGNED. I ACKNOWLEDGE THAT I HAVE SIGNED THIS OF MY OWN FREE WILL, THAT THIS DOCUMENT MAY AFFECT MY LEGAL RIGHTS, AND THAT MY OR MY CHILD’S PARTICIPATION IN MOUNTAINEERS ACTIVITIES IS PURELY VOLUNTARY. Your E-Mail Address Partner Program Please name the partner program the participant is enrolled in. Start Date of Program Participant Full Name Participant Signature By checking this box, I’m confirming my signature on this form. Participant Date of Signature FOR MINORS (Under 18 Years Old) Parent/Guardian Full Name Parent/Guardian Signature By checking this box, I’m confirming my signature on this form. Parent/Guardian Date of Signature