R16, 2017-05-11

NOTE: Smoky Mountain River Rat does not accept paper waivers, please submit electronically.

Please select who will be participating:

First Minor's Information

Second Minor's Information

Third Minor's Information

Fourth Minor's Information

Fifth Minor's Information

Sixth Minor's Information

River Rat Release of Liability

In consideration of being allowed to participate in any way, in the Smoky Mountain River Rat, Inc., d/b/a River Rat Program, its related events and activities, I the undersigned, acknowledge, appreciate and agree that:

  • 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 the risk, the risk of serious injury does exist and,
  • I KNOWLINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and I assume full responsibility for my participation; and
  • 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 or participation, I will remove myself from participation and bring such to the attention of the company immediately; and
  • I willingly agree to comply with the inherent risks of physical participation in any and all rope swings, jump rocks, and other extra activities on the river.
  • I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY AND HOLD HARMLESS, Smoky Mountain River Rat, Inc., d/b/a River Rat Program, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releasees”), the United States and the State of Tennessee, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to persons or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE to the fullest extent permitted by law.


Finally, I hereby irrevocably consent to and authorize, Smoky Mountain River Rat, Inc., d/b/a River Rat Program to use and reproduce any and all photographs and videos taken of me for any purpose whatsoever, without further compensation to me. All such photographs and videos, including negatives and the like are solely the property of Smoky Mountain River Rat, Inc., d/b/a River Rat.

I have read this Release of Liability and Assumption of Risk Agreement, and fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

Please enter your legal name as it appears on your passport/Driver's License.


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Signature

By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.