Visitor'S Acknowledgement Of Risks - United States Department Of The Interior printable pdf download

United States Department of the Interior

NATIONAL PARK SERVICE

John Day Fossil Beds National Monument

32651 Hwy 19

Kimberly, Oregon 97848

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 (hereinafter 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.

[include description of risks]

I am aware that ________________________________ entails risks of injury or death to any participant. I understand that 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 than 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 myself, my heirs, assigns, personal representative and estate and for all members of my family,

including minor children.

_____________________________________

______________

Signature

Date

Under 18, signature of parent or guardian:

_____________________________________

______________

Signature

Date

Visitor'S Acknowledgement Of Risks - United States Department Of The Interior