August 12, 2023 Kayak Event

APPLICATION AND WAIVER OF LIABILITY

A FATHER FOREVER’S 17TH ANNUAL KAYAK DAY AT NEW PORT BEACH
AUGUST 12, 2023
“A Father Forever, Cliff Meidl Enterprises and Newport Aquatic Center” its officers, employees and agents are removed from all claims including negligence of the organization’s officers, employees and agents, resulting in personal injury accidents or illness (including death), and property loss arising from, but not limited to, participation in the A Father Forever 17th Annual Kayak Day. I understand that A Father Forever, Cliff Meidl Enterprises and Newport Aquatic Center will utilize reasonable care to ensure a safe environment to the best of their abilities for all members participating in this kayak event. I knowingly and willingly assume all risks in this kayak day endeavor and I (we) will practice safe methods throughout the day.

* Indicates required field

Name (Parent/Guardian) *

First

Last

Phone Number *

Date *

Please print name, age of all minors under 18, and relationship of all members and minors in your group. *

EMERGENCY CONTACT PERSON: *

EMERGENCY CONTACT PHONE #: *

Electronic Signature
By electronically printing my name below, I state that I understand and will adhere to the Statement of Confidentiality, Photo Consent Policy, Health and Safety Policy and agree to the terms of the Waiver of Liability and Release Statement.

Name *

Date *

YOU WILL RECEIVE A CONFIRMATION NUMBER. IF YOU DO NOT RECEIVE AN EMAIL WITH A CONFIRMATION NUMBER, CALL US IMMEDIATELY AT 323-618-1900

Submit

You can also download Application and Waiver of Liabilty(Word)
Email form to: [email protected]

Application and Waiver of Liabilty