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GENERAL LIABILITY WAIVER
                              
                                                  
                                                                         

PLEASE PRINT CLEARLY AND FILL OUT COMPLETELY

NAME________________________________________________________________________________

MAILING ADDRESS____________________________________________________________________

CITY___________________________ STATE___________________________ ZIP_________________

BILLING ADDRESS____________________________________________________________________

CITY STATE ZIP

PHONE___________________________________FAX________________________________________

EMAIL ADDRESS______________________________________________________________________

AGE___________________________WEIGHT________________________SEX___________________

OCCUPATION_________________________________________________________________________

MEDICAL CONDITIONS WE SHOULD KNOW ABOUT_____________________________________

WHO TO NOTIFY IN CASE OF EMERGENCY______________________________________________

TEL#___________________________________RELATIONSHIP TO YOU________________________

DATE OF LESSON___________________ LOCATION__________________TIME_________________

IS THIS YOUR FIRST LESSON WITH DAKINE SURF, LLC? ____________________

HOW MANY KITEBOARDING LESSONS HAVE YOU HAD WITH DAKINE SURF, LLC?

____________________________________________________________________________________

DO YOU PLAN ON CONTINUING YOUR KITEBOARDING TRAINING? _____________________

In consideration for the renting, purchasing, or leasing of Kiteboarding equipment from DAKINE SURF, LLC

and/or utilizing of the facilities, ground school, instruction, premises, and equipment of DAKINE SURF, LLC in

engaging in the sport of Kiteboarding, ground instruction, water instruction, and related activities (hereinafter

collectively called Kiteboarding”), I hereby understand and agree to this release of liability, waive of legal rights, and

assumption of risk, and to the terms hereof as follows:

1. I acknowledge that Kiteboarding is an action sport and recreational activity involving travel in three

dimensions and such activity is subject to mishap and even injury to participants. I understand that

I may suffer a broken limb, paralysis, or fatal injury while participating in the sport of Kiteboarding.

Initial Here______________

2. I further acknowledge that there are no warranties applicable to the purchase of the Kiteboarding

equipment by me and that all warranties whether expressed or implied are excluded. THERE IS

NO WARRANTY OF MERCHANTABILITY OR THAT THE SAID KITEBOARDING

EQUIPMENT IS FIT FOR PURPOSE. I am accepting the said Kiteboarding equipment as is and I

hereby acknowledge that I will personally examine the said Kiteboarding equipment prior to my

using the same.

Initial Here______________

3. I hereby release and discharge DAKINE SURF, LLC, the state of Hawaii, ect.

ect. ect. and their officers, directors, elected officials, agents, employees, instructors, lessors, and

owners of equipment and the land used for Kiteboarding Activities (hereinafter referred to as

“Release Parties”), from any and all liability, claims, demands, or causes of action that I may

hereafter have for injuries, disability, or death, or damages arising out of my participation in

Kiteboarding Activities, including, but not limited to, losses CAUSED BY THE NEGLIGENCE OF

THE RELEASED PARTIES.

Initial Here______________

4. I understand and acknowledge that Kiteboarding Activities have inherent dangers that no amount of

care, caution, instruction, or expertise can totally eliminate. I EXPRESSLY AND

VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED

WHILE PARTICIPATING IN KITEBOARDING ACTIVITIES WHETHER OR NOT CAUSED

BY THE NEGLIGENCE OF THE RELEASED PARTIES.

Initial Here______________

5. I further agree that I WILL NOT SUE OR MAKE A CLAIM against the released parties for

damages or other losses sustained as a result of my participation in Kiteboarding Activities.

Initial Here______________

6. I also agree to INDEMNIFY AND HOLD THE RELEASED PARTIES HARMLESS from all

Claims, judgments and costs, including attorneys’ fees, incurred in connection with any action

brought as a result of my participation in Kiteboarding Activities.

Initial Here______________

7. I will take full responsibility for, and hold harmless, Released Parties for any injury that I

may suffer or inflict upon others or their property as a result of my engaging in Kiteboarding

Activities.

Initial Here______________

8. I agree that I will operate the said Kiteboarding equipment in a reasonable and safe manner so as not

to endanger the lives of persons or property of any individual.

Initial Here______________

9. I have read and understand the above and acknowledge that the same constitutes a release a liability

and a waiver of my legal rights and also acknowledgment of the assumption by me of all risks

arising out of my engaging in kiteboarding Activities.

Initial Here______________

10. I further represent that this release of liability, waiver of legal rights, and assumption of risk shall

continue in full force and effect for so long as I engage in Kiteboarding Activities which are in any

way connected to or with the Released Parties.

Initial Here______________

11. I further represent that I am at least 18 years of age or that as the parent or legal guardian I waive

and release any and all legal rights that may accrue to me or to my minor child as the result of any

injury that my son or daughter (minor) may suffer while engaging in Kiteboarding Activities.

Initial Here______________

12. I hereby expressly recognize this Release of Liability, Waiver of Legal Rights, and Assumption

of Risk is a contract pursuant to which I have released any and all claims against the Released

Parties resulting from my participation in Kiteboarding Activities including any claims by the

negligence of Released Parties.

Initial Here______________

I HAVE READ THIS RELEASE OF LIABILITY, WAIVER OF LEGAL

RIGHTS, AND ASSUMPTION OF RISK, AND FULLY UNDERSTAND ITS

CONTENTS AND SIGN IT OF MY OWN FREE WILL.

THIS THE_____________DAY OF_________________, 20_________________

Name of Adult Student (print) of DAKINE SURF, LLC Signature of Adult Student of DAKINE SURF, LLC

___________________________________________________________________

Name of Minor Child (print) who will use DAKINE SURF, LLC

___________________________________________________________________

Name of Parent/ Guardian of Minor Child Under 18 years of age (print)

___________________________________________________________________

 

 

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