Visitor's Acknowledgement of Risks Form

ADVERTISEMENT
EXHIBIT 2:
Sample Acknowledgement of Risk Form
VISITOR’S ACKNOWLEDGEMENT OF RISKS
In consideration of the services of _____________________ their officers, agents, employees, and
stockholders, and all other persons or entities associated with those businesses (hereafter collectively referred to
as “______________”) I agree as follows:
Although _____________________ has taken reasonable steps to provide me with appropriate
equipment and skilled guides so I can enjoy an activity for which I may not be skilled, _____________________
has informed me this activity is not without risk. Certain risks are inherent in each activity and cannot be
eliminated without destroying the unique character of the activity. These inherent risks are some of the same
elements that contribute to the unique character of this activity and can be the cause of loss or damage to my
equipment, or accidental injury, illness, or in extreme cases, permanent trauma or death.
_____________________ does not want to frighten me or reduce my enthusiasm for this activity, but believes it is
important for me to know in advance what to expect and to be informed of the inherent risks. The following
describes some, but not all, of those risks.
[enter description of risks]
I am aware that _____________________ entails risks of injury or death to any participant. I understand
the description of these inherent risks is not complete and that other unknown or unanticipated inherent risks may
result in injury or death. I agree to assume and accept full responsibility for the inherent risks identified herein and
those inherent risks not specifically identified. My participation in this activity is purely voluntary; no one is forcing
me to participate, and I elect to participate in spite of and with full knowledge of the inherent risks.
I acknowledge that engaging in this activity may require a degree of skill and knowledge different from
other activities and that I have responsibilities as a participant. I acknowledge that the staff of
_____________________ has been available to more fully explain to me the nature and physical demands of this
activity and the inherent risks, hazards, and dangers associated with this activity.
I certify that I am fully capable of participating in this activity. Therefore, I assume and accept full
responsibility for myself, including all minor children in my care, custody, and control, for bodily injury, death, or
loss of personal property and expenses as a result of those inherent risks and dangers identified herein and those
inherent risks and dangers not specifically identified, and as a result of my negligence in participating in this
activity.
EXHIBIT 2:
Sample Acknowledgement of Risk Form
VISITOR’S ACKNOWLEDGEMENT OF RISKS
In consideration of the services of _____________________ their officers, agents, employees, and
stockholders, and all other persons or entities associated with those businesses (hereafter collectively referred to
as “______________”) I agree as follows:
Although _____________________ has taken reasonable steps to provide me with appropriate
equipment and skilled guides so I can enjoy an activity for which I may not be skilled, _____________________
has informed me this activity is not without risk. Certain risks are inherent in each activity and cannot be
eliminated without destroying the unique character of the activity. These inherent risks are some of the same
elements that contribute to the unique character of this activity and can be the cause of loss or damage to my
equipment, or accidental injury, illness, or in extreme cases, permanent trauma or death.
_____________________ does not want to frighten me or reduce my enthusiasm for this activity, but believes it is
important for me to know in advance what to expect and to be informed of the inherent risks. The following
describes some, but not all, of those risks.
[enter description of risks]
I am aware that _____________________ entails risks of injury or death to any participant. I understand
the description of these inherent risks is not complete and that other unknown or unanticipated inherent risks may
result in injury or death. I agree to assume and accept full responsibility for the inherent risks identified herein and
those inherent risks not specifically identified. My participation in this activity is purely voluntary; no one is forcing
me to participate, and I elect to participate in spite of and with full knowledge of the inherent risks.
I acknowledge that engaging in this activity may require a degree of skill and knowledge different from
other activities and that I have responsibilities as a participant. I acknowledge that the staff of
_____________________ has been available to more fully explain to me the nature and physical demands of this
activity and the inherent risks, hazards, and dangers associated with this activity.
I certify that I am fully capable of participating in this activity. Therefore, I assume and accept full
responsibility for myself, including all minor children in my care, custody, and control, for bodily injury, death, or
loss of personal property and expenses as a result of those inherent risks and dangers identified herein and those
inherent risks and dangers not specifically identified, and as a result of my negligence in participating in this
activity.
I have carefully read, clearly understood, and accepted the terms and conditions stated herein and
acknowledge that this agreement shall be effective and binding upon me, my heirs, assigns, personal
representative, and estate and for all members of my family, including minor children.
_______________________________
_____________________
Signature
Date
Signature of Parent of Guardian, if participant is under 18 years of age
_____________________________
_____________________
Signature
Date

Download Visitor's Acknowledgement of Risks Form

162 times
Rate
4.7(4.7 / 5) 10 votes
ADVERTISEMENT
Page of 2