RELEASE OF LIABILITY AND STIPULATED DAMAGES AGREEMENT

 

All persons must read and sign this agreement before participating

PLEASE RETURN WITH YOUR DEPOSIT/PAYMENT or EMAIL IT BACK!

 

 

I,  ________________________,   acknowledge that I have voluntarily applied to participate in program.

 

I recognize that the activities of boating on open ocean and shores, driving on roads and highways, hiking around shorelines and on trails, and swimming in streams, rivers and the ocean and all other hazards and exposure connected with these activities do involve risks and dangers inherent with these activities.  I acknowledge that in consideration for being allowed to take part in the program with Tania Massamiri, I accept and assume all of the dangers that are inherent in all the above activities, whether or not these dangers are obvious or necessary.

 

I understand and agree that any bodily injury, death or loss of personal property and expenses thereof that occur as a result of my participating in these activities are my responsibility.  In the event that any damages are to be paid, they shall not exceed the amount of consideration I have paid.  And if litigation is pursued after payback of consideration has been tendered, all legal expenses of both parties shall be borne by the party bringing forth litigation.

 

I hereby certify that I am in good health and that I am physically and mentally capable of handling the hazards of boating, swimming, weather conditions, and exposure to animals, mammals and fish, walking, dancing, and all other conditions associated with the program and Tania Massamiri.  I understand the risks and stress of swimming and snorkeling in the ocean and also certify that prior to my arrival for this scheduled trip I will be sufficiently capable and comfortable with using mask, snorkel and fins to safely conduct myself in the ocean.

 

In consideration of my participation in the program, I do hereby release Tania Massamiri and their agents, employees from any legal liability for any and all injury or death caused by or resulting from my participation in the program activities from any cause.

 

Furthermore, I hereby waive, release and discharge Tania Massamiri and their representatives, successors and assigns for any and all losses of property, personal injuries, damages and claims, even injuries resulting in death by any cause that I might sustain as a result of taking part in the program.

 

I agree that this agreement is to bind me, my heirs, my estate, legal guardians and personal representatives.

 

I agree that this release and waiver agreement is intended to be as broad and inclusive as permitted and that if any part of this agreement is held invalid, I agree that the rest shall continue to have full legal force and effect.

                                                            

In signing this agreement I hereby certify that I am over the age of 18 years and have read and fully understand the terms and conditions set forth above.  Or, in signing this agreement the participant’s guardian unconditionally waives, releases, and discharges any claims for personal injury, property damage or wrongful death against Tania Massamiri, any designated facilitators, hired employees, companies and their crew, or it’s owners and further releases same from any legal actions or causes which may arise for me or for my estate, my heirs, executors, administrators and assigns.

 

THIS IS A RELEASE OF LIABILITY AND A STIPULATED DAMAGES AGREEMENT.  DO NOT SIGN THE AGREEMENT IF YOU DO NOT UNDERSTAND OR DO NOT AGREE WITH ITS TERMS.

 

_______________________________________Participant signature

 

Print name ______________________________

Address:

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