NAME
ADDRESS ___________________________________________________________
PHONE ______________ FAX _______________ EMAIL _________________
BOAT MAKE _____________________ BOAT NAME ________________________
Release of Liability
(Clearly Print Your Name) I _______________________________, am aware that using a watercraft exposes me to certain hazards, including but not limited to injury or death, illness or medical emergency, including the risk of drowning; and damage to loss or theft of vessel and/or equipment or other personal possessions, during the use of the watercraft, including the transporting of the vessel and equipment.
I hereby release, indemnify and hold harmless Reeling for Kids along with the Boys & Girls Club and all of their owners, agents, event organizers, officials, sponsors, or anyone else associated with this event from any and all liabilities, cause of action , claims, demands, costs or debts of any nature, arising our of negligence or otherwise. I assume all risks of the vessel and equipment, in transport and use by myself, and all of the potential hazards and dangerous conditions associated with its use and transport.
I assume responsibility for all such risks and hazards associated with this event.
SIGNATURE _______________________________ DATE __________________
Proceeds Benefitting the Boys & Girls Club of Alachua County