FINGER LAKES SEA KAYAKERS
STATEMENT ON SAFETY
____________________________________________________________________________________________

To be completed before participating in group events.

This document may affect your legal rights, so please read it carefully.

The intent of this form is to enhance your safety. Specifically, please be aware that you alone are responsible for any risks encountered during our activities.

These risks include but are not limited to automobile accidents, hypothermia, drowning, getting lost, boat capsize, tidal conditions, collision with other boats or rocks, aggressive and possibly poisonous organisms, bodily injury, being sued by other unwilling to accept responsibility for their own actions, death, and exposure to the sun, strong wind, large waves, storms, lightning and cold.

The Finger Lakes Sea Kayakers is a group of friends who get together to discuss and enjoy sea kayaking.  The various members of the group, and the group itself, cannot take responsibility for your actions. You are ultimately responsible for your own actions.   Do not blindly follow others while kayaking; instead, try to understand what is going on and assess the risks to yourself.  Always speak up when you feel something is not right, or when you have reached your limits.

In signing this form, I am agreeing that I have read this statement and understand there are risks, including that of death, involved in my participation with Finger Lakes Sea Kayakers.  I accept these risks, and hold the Finger Lakes Sea Kayakers and its members harmless. I understand that the Finger Lakes Sea Kayakers do not provide insurance, and certify that I  have adequate insurance to cover any injury or damage I may cause or suffer while participating, or agree to bear the costs of such injury or damage myself.  I also certify that I have no medical condition or physical condition  which could interfere with my safety while participating, and agree that I will assume bear all the costs and risks associated with, directly or indirectly, with any such condition.

I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the Finger Lakes Sea Kayakers  from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity, including claims which allege negligent acts or omissions.

I agree to go out and have some fun kayaking!

Name:  ______________________________         Signature: ____________________________

Address: _____________________________         Date:        ____________________________
              
               _____________________________

Phone:     _____________________________         Email:    _____________________________

In an Emergency Contact: ______________________________________________________________