Event Participation Wavier & Release

Is the participant under 18 years old?

Yes
No

Participant Information

Participant Name (First and Last)

Participant Age

Would you like to provide authorization for more than 1 under age participant?

Yes
No

Participant 2 Name (First and Last) (copy)

Participant 2 Age

Participant 3 Name (First and Last)

Leave blank if do not need

Participant 3 Age

Leave blank if do not need

Emergency Contact Information

Name

First

Last

Phone

I grant permission for HERO to use photographs or video taken during the event for promotional, educational, or fundraising purposes.

Yes
No

Minor Participant Authorization

I agree to the following:

I am the parent or legal guardian of the minor(s) participant(s) listed above.

I give permission for my child/children to participate in activities hosted or organized by Healing at English River Outfitters (HERO), which may include but are not limited to outdoor activities, physical challenges, hunting/fishing related experiences, community events, and travel between activity locations.

Medical Authorization for Minor
In the event of injury or medical emergency, I authorize HERO staff, volunteers, or event coordinators to seek medical treatment for my child/children.

Is the minor(s) attending with another adult?

Yes
No

Supervising Adult at Event

I authorize the adult listed below to supervise my child during the event.

Name

First

Last

Assumption of Risk

I understand that participation in HERO activities involves inherent risks including but not limited to:

– Uneven terrain
– Outdoor environmental conditions
– Physical exertion
– Equipment use
– Transportation between locations
– Interaction with other participants

I voluntarily assume all risks associated with participation.

and Last) Participant

Release of Liability

I agree to the following:

To the fullest extent permitted by law, I release and hold harmless Healing at English River Outfitters (HERO), its board members, officers, volunteers, event sponsors, property owners, and partners from any and all claims, injuries, damages, or losses arising from participation in HERO activities.

Agreement & Signature

I have read and understand this waiver and agree to its terms.

Signature

Clear Signature

Participant Signature (if 18+) Parent/Guardian Signature (required if minor)

Participant Information

Emergency Contact Information

Supervising Adult at Event

Agreement & Signature

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