Health Waiver-Rope Spoke & Paddle

Health Waiver

Group or Company Name

First Name

Last Name

Date of Birth

Email

Phone Number

Address

Activity Details

Activity Name

Date of Activity

Medical Information

Do you have any medical conditions or allergies which we should be aware of which may affect your ability to participate or which may require sudden treatment during the event?

Yes

No

If you answered "Yes" to the previous question, please provide details.

Do you have any dietary requirements?

Yes

No

If you answered "Yes" to the previous question, please provide details.

Emergency Contact Details

Full Name

Phone Number

Relationship to Emergency Contact

Disclaimer

Acknowledgment of Risk: I, the undersigned, acknowledge that I am voluntarily participating in activities at The RSP Off-Grid Adventure Centre. I understand that these activities are “assumed risk” sports that may carry attendant risks, including, but not limited to, physical injury, illness, or even death.

I agree to the above statement

Assumption of Responsibility: I accept responsibility for my own actions and involvement. I declare that I am physically fit for the activity I am participating in and have disclosed all relevant medical conditions on the booking form. I agree to communicate any new medical conditions to the instructor on the first day of the activity.

I agree to the above statement

Compliance with Safety Guidelines: I agree to adhere to all safety instructions provided by the instructors and use the provided safety gear as directed. I understand that any unsafe behaviour will result in immediate removal from the activity without a refund.

I agree to the above statement

Zero Alcohol and Drugs Policy: I acknowledge that the consumption of alcohol or drugs is strictly prohibited during all activities with RSP. I understand that if I am suspected of being under the influence, I will not be allowed to join the activities and may be asked to leave the premises without a refund.

I agree to the above statement

Media Consent: I consent to being photographed and/or filmed during the activities for promotional purposes on RSP’s website, social media, and other marketing materials, unless I have informed RSP in writing that I do not wish to be photographed or filmed.

I agree to the above statement

Release of Liability: I release The RSP Off-Grid Adventure Centre and its instructors from any liability for injuries, illnesses, or damages incurred during the activities, except where negligence is proven. I understand that RSP reserves the right to modify or cancel activities due to safety concerns or unforeseen circumstances without liability.

I agree to the above statement

Insurance Recommendation: I acknowledge that RSP recommends obtaining personal insurance to cover any potential risks associated with adventure sports, as RSP accepts no liability for injuries, illnesses, or damages incurred during the activities, except where negligence is proven.

I agree to the above statement

Your Signature

*

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