Appalachian Watersports & Charters, LLc Waiver and Liability Agreement for persons participating in watersports/ and or charters.

AGREEMENT Please print clearly Name: _____________________________________________________ Age: _____ Address: ____________________________________ City: ______________ State: ______ Zip: ______ Telephone: (___) ____-________ E-Mail: __________________________________________________ **NAME AND PHONE NUMBER OF PERSON TO CONTACT IN THE EVENT OF AN EMERGENCY: Name:________________________________________________ Phone: (_____)______-_________ NOTE TO THE PARTICIPANT Participation in any water sport or being on/near the water exposes the participant to certain risks and dangers. Accidents and injuries (superficial to fatal) resulting from the forces of Mother Nature, other boaters, malfunctioning equipment, unseen obstacles, fatigue, unintentional collisions by the operator of the vessel you are traveling on and your own misjudgment are a very real possibility. Appalachian Watersports & Charters, LLc considers safety to be its utmost concern and as such, its staff includes individuals trained in lifesaving, water safety instruction, C.P.R., and AHA First Aid. The nature of these sports and activities, however, makes it impossible to foresee and protect the participant from all conceivable dangers associated with water and water sports. Once the participant leaves the safety of the shore and enters the vessel and or water, he/she must be prepared to assume all risks associated therewith. AFFIRMATION AND LIABILITY RELEASE THE UNDERSIGNED CERTIFY THAT THEY HAVE READ THE FOREGOING PRIOR TO THE SIGNING THEREOF AND AGREE AS FOLLOWS: 1. I hereby affirm that I understand the inherent dangers of wake surfing, wake boarding, tubing, swimming and traveling in a vessel. 2. I hereby agree to indemnify and hold harmless Appalachian Watersports & Charters, LLc, and staff from any and all liability for any harm, injury, death, or damages (physical, mental, or monetary), regardless of fault or negligence, which may befall me while participating in this program or while using Appalachian Watersports & Charters, LLc vessels. This release shall be binding upon my family, heirs, and administrators. 3. The undersigned here by certifies that the participant is a proficient swimmer, has up to date medical insurance, physically and mentally well enough and agrees that they are able to make good decisions while participating with Appalachian Watersports & Charters, LLc. participant agrees to wear a life vest. 4. I hereby agree to heed at all times the advice and instructions of Appalachian Watersports & Charters, LLc staff and to practice common sense water safety procedures. 5. To the extent provided by State Law, I also freely and voluntarily waive all claims for damages or loss to my person or property, or the person or property of third parties, that may be caused by an act, or failure to act, of the Tennessee DNR or its agents and employees, and release the Tennessee DNR and the State of Tennessee from any and all claims. I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT TO THE BEST OF MY KNOWLEDGE: Date: ___/___/_____ Participant Signature: _________________________________________________ Date: ___/___/_____ Parent/Guardian (If under 18): __________________________________________

Additional parties please print and sign:

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