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Release Form

Please read and initial next to each statement below:

I am over the age of 18 years old.

I understand the risks (the “Risks”) of the above mentioned activity or activities, including without limitation, injury (whether physical or emotional or relating to property), falls, fractures, seizures, concussions, property damage, disability, death, disfiguration, loss of consortium, theft, criminal acts, environmental elements (weather, landscaping, terrain difficulties, hostile or aggressive wildlife, animal or bug bites/stings/injuries, etc.), overheating, overexertion, physical strains, collisions, fire, drowning, traffic, injuries resulting in whole or in part from my negligence or inability to avoid or evade obstacles or other hazards, injuries resulting from my lack of fitness or conditioning, dangerous or defective equipment, willful acts or negligence of others, loss of control, equipment failure, burns or cuts, allergic reactions, food-borne illnesses, and/or those caused by terrain, facilities, temperature, weather, physical/mental/emotional condition of participants, equipment, lack of hydration, premises design or lighting, obstacles or premises defects regardless of whether concealed or obvious, actions or omissions by other participants or third-parties interfering with the activity or contributing to any of the foregoing risks, any other risks reasonably foreseeable in connection with the activity, and any other risks disclosed by the host of the activity or activities. I agree to assume all of the foregoing Risks. I also agree to follow any and all instructions given to me by the activity host.

I understand and agree that I alone am responsible for my safety during this activity. While the activity host may take certain precautions, it is my responsibility to act in a reasonably safe manner at all times during the activity, including towards others.

I have not been advised against participating in the above mentioned activity or activities by any professional or medical doctor. I certify that there are no health-related reasons or other problems which preclude my participation from this activity.

I hereby agree to forever release, waive, discharge, and covenant not to sue the activity host, its directors, officers, employees, vendors, contractors, guests, event participants, attendees, invitees, associates, and affiliates and hold the foregoing harmless from any liability related to the preparation for, participation of, or the after-effects of the foregoing activity or activities and their Risks, including without limitation, causes of action of every kind, whatsoever, whether or
not asserted, known, unknown, now-existing, hereafter arising, or the future revelation of such claims, including without limitation, those damages from willful acts or omissions and acts of passive or active negligence, including gross negligence, on the part of the host, and expressly waive any such claims.

I give permission for the activity host (including its vendors or authorized agents) to take photographic or video recordings that may be used for social media, websites, promotional, or educational use. I understand that my image may be edited, copied, published, or distributed and waive any right to inspect or approve the finished product(s) wherein my likeness appears. Additionally, I grant an unconditional license to the host for the foregoing and my likeness and waive any right to royalties or compensation related to the use of such images or recordings.

By signing below, I have read the foregoing and fully understand the benefits, risks, and alternatives involved in the foregoing activity or activities and have had the opportunity to ask questions, in which all have been answered to my satisfaction. I further certify that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims, now existing or future arising, against any person or organization utilizing this material for business or promotional purposes and will hold them harmless from any liability that may result from the foregoing.

Please select the option that best describes you:

Thanks for submitting!

Please note that in order to participate in High-Five Society events, you will need to complete the Photo Consent Form in addition to the Release Form (this form).

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