AMERICAN CANOE ASSOCIATION, INC.
WAIVER AND RELEASE OF LIABILITY
READ BEFORE SIGNING
IN CONSIDERATION of being permitted to participate in any way in the American Canoe
Association, Inc. sports and recreation program and related activities (“Activities”) I, for myself,
my personal representatives, assigns, heirs, and next of kin:
1. ACKNOWLEDGE, agree, and represent that I understand the nature of Paddlesports and
related Activities and that I am qualified, in good health, in proper physical condition to participate
in such Activity and willingly agree to comply with the stated and customary terms and conditions
of participation. I further agree and warrant that if at any time I believe conditions to be unsafe, I
will immediately notify the nearest official and discontinue further participation in the Activity.
2. FULLY UNDERSTAND that: (a) Paddlesports and related ACTIVITIES INVOLVE RISKS
AND DANGERS OF DAMAGE TO PERSONAL PROPERTY AND SERIOUS BODILY
INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS");
(b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions
of others participating in the Activity, the condition in which the Activity takes place, or THE
NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISKS
AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable
at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL
RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my
participation or that of the minor in the Activity.
3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE American Canoe
Association, Inc., its Paddle America Clubs, affiliated clubs and organizational affiliates, their
respective ACA certified instructors, certified instructor trainers, and certified instructor trainer
educators, administrators, directors, agents, officers, members, volunteers, and employees, other
participants, any sponsors, advertisers, and, if applicable,owners and lessors of premises on which
the Activity takes place, (each considered one of the "RELEASEES" herein)FROM ALL
LIABILITY, CLAIMS, DEMANDS, LOSSES, INJURIES, DAMAGE TO PROPERTY, OR
OTHER DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN
WHOLE ORIN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE,
INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if,
despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND
INDEMNITY AGREEMENT I, or anyone on my behalf,makes a claim against any of the
Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE
RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which
any may incur as the result of such claim.
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND
THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED
IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE
AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL
LIABILITY TO THE GREATESTEXTENT ALLOWED BY LAW AND AGREE THAT IF
ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE,
NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

PRINTED NAME OF PARTICIPANT:___________________________________________________

SIGNATURE:_______________________________________________________________________

ADDRESS:_______________________________________________________________________
                                (Street)                                 (City)                                         (State)             (Zip)

DATE OF BIRTH: _______________ ACA #: _____________________________

CLUB/ORGANIZATION: ______________   PHONE: (_____)________________

REVISED 2/05


FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
AND I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN,
UNDERSTAND THE NATURE OF PADDLESPORTS AND RELATED ACTIVITIES
AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE
MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL
CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE,
DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND
SAVE AND HOLDHARMLESS EACH OF THE RELEASEE'S FROM ALL LIABILITY,
CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT
CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE
OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS
AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE,
I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST
ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD
HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY
FEES, LOSSLIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY
SUCH CLAIM.

PRINTED NAME OF PARENT/GUARDIAN:___________________________________________

ADDRESS:_______________________________________________________________________
                                (Street)                                 (City)                                         (State)         (Zip)
PHONE: (____)_________________________

PARENT/GUARDIAN SIGNATURE
(only if participant is under the age of 18):_____________________________________________

DATE:____________________________

REVISED 2/05