I, ___________________________________, being an adult, (or a minor on whose behalf a parent or legal guardian is signing this document) (hereafter “I” or “me”), acknowledge that:
1) I Know How To Ride A Bicycle And I Am In Good Health: My bicycling skills are above those of a novice and I can maintain control of a bicycle in all types of terrain and weather conditions. Likewise, I am in good physical and mental health, I am not under the influence of any drugs, alcohol, or other substances which may impair my balance or my ability to take and follow instructions. I am not pregnant nor am I suffering from any spinal or skeletal defect, hearing, vision or balance impairment or other physical impairment. I understand that the foregoing representations as to my physical condition are being relied upon by GALAPAGOS SURF DISCOVERY. I hereby agree to follow all rules, regulations, and instructions of GALAPAGOS SURF DISCOVERY while participating in this activity or while renting equipment from GALAPAGOS SURF DISCOVERY.
2) I Acknowledge That Bicycling May Be Dangerous And I Accept And Assume Such Risk: I am aware that riding a bicycle involves inherent risks. I may damage my belongings, get hurt, get injured, become ill, or even die. I further acknowledge that I have voluntarily chosen to rent equipment from or go on a bicycling excursion with GALAPAGOS SURF DISCOVERY, or if the individual participating in such activities or renting equipment is a minor, I have, as the minor’s parent or legal guardian, voluntarily consented to such minor participating in the activity or renting equipment. I know and fully understand that adventure sports such as bicycling are dangerous outdoor activities in an uncontrolled natural environment with inherent risks and hazards, where serious accidents can occur, participants can sustain property damage, injuries, illness and even die. I acknowledge and willingly and voluntarily assume all risks and hazards while bicycling and during all related activities from the transportation to the site until the conclusion of the tour or equipment rental period, including, but not limited to those involving (1) loss of control of the bicycle or other equipment, malfunction of the bicycle or other equipment, falls from the bicycle or other equipment, collision with other participants, equipment, other bicycles, motorized vehicles, rocks, and any other manmade or natural obstacles, whether obvious or not; (2) judgment, decision making and conduct of the tour guide; (3) encounters with animals, plant life, rocks and insects; (4) exposure to outdoor environments, bacteria or microbes, extreme temperatures, sun, and inclement weather, including travel by foot or vehicle in any way related to this activity; (5) assistance in lifting and/or carrying bicycling equipment; (6) rescue-related injuries; and (7) unavailability of immediate and appropriate medical attention in case of injury. I understand and acknowledge that the above list is not meant to be complete or exhaustive; that other unforeseen and unanticipated risks, known or unknown, may also exist and result in damage, injury, illness, disease, or death.
3) Responsibility For Additional Costs And Equipment Rented: I understand that I am responsible for any costs not included explicitly in the description of the activity. I have reviewed each piece of equipment that I am renting to ensure it is in good condition. I understand that I will be charged its real value in case of damage or loss.
4) I Waive My Right To Sue GALAPAGOS SURF DISCOVERY: In consideration for GALAPAGOS SURF DISCOVERY agreeing to provide me with equipment rental or bicycling instructions and/or allowing me to participate in this tour activity, I agree that I shall not make a claim or bring any action against, sue, or hold responsible, GALAPAGOS SURF DISCOVERY, its owners, officers, agents, employees, associates, representatives, (referred to collectively in this agreement as “GALAPAGOS SURF DISCOVERY”) or expect, require, or pursue them, to be held accountable for any damages. I voluntarily agree to release, discharge, and hold harmless GALAPAGOS SURF DISCOVERY from and against any and all claims of liability, even those arising out of their negligence, fault, recklessness, or any other act or omission which causes me damages, property damage, illness, personal injury, disease, or death, of any nature in any way connected with my participation in this activity. I also expressly agree to release and discharge GALAPAGOS SURF DISCOVERY from any act or omission, excluding acts of wanton or gross negligence, in rendering or failing to render any type of rescue, emergency or medical services.
5) Indemnity: I further agree, to hold harmless, defend, and indemnify GALAPAGOS SURF DISCOVERY from all defense costs, including attorney’s fees incurred in connection with any claims arising from the activities anticipated herein, including but not limited to those for bodily injury, wrongful death, or property damage, whether caused by or sustained by any minor under 18 years of age on whose behalf I am signing, or which I may have caused to spectators or other third parties, whether negligent or not, in the course of my participation in this activity.
6) Permission to Obtain Medical Assistance: In the event of any injury, illness, emergency, accident or other harm sustained by me (or by the minor on whose behalf I am signing this document), I hereby give GALAPAGOS SURF DISCOVERY permission to obtain Medical Assistance, in which event I hereby make the same releases and waivers in GALAPAGOS SURF DISCOVERY’s favor as I have otherwise made in this agreement in connection with any such medical assistance sought or not sought. In addition, the expenses for any such medical emergency shall be my sole responsibility and not that of GALAPAGOS SURF DISCOVERY.
7) I HAVE READ THIS DOCUMENT IN ITS ENTIRETY AND IT IS MY INTENTION THAT IT BE BROADLY CONSTRUED IN FAVOR OF GALAPAGOS SURF DISCOVERY IN THE EVENT OF ANY AMBIGUITIES, WHICH SHALL BE RESOLVED IN GALAPAGOS SURF DISCOVERY’S FAVOR. I UNDERSTAND THAT I AM ASSUMING ALL THE RISKS INHERENT IN THIS BICYCLING ACTIVITY, AND THAT I MAY BE INJURED OR EVEN DIE AS A RESULT OF BICYCLING. I UNDERSTAND THAT THIS IS A RELEASE OF ANY AND ALL CLAIMS. I UNDERSTAND THAT THIS IS THE ENTIRE AGREEMENT BETWEEN ME AND GALAPAGOS SURF DISCOVERY, AND THAT NO REPRESENTATIONS HAVE BEEN MADE TO ME BY GALAPAGOS SURF DISCOVERY OUTSIDE OF THIS AGREEMENT. I VOLUNTARILY SIGN MY NAME AS EVIDENCE OF MY ACCEPTANCE OF ALL THE PROVISIONS IN THIS RELEASE AND MY AGREEMENT TO BE BOUND BY THEM.
Full Name of Participant ___________________________________________________________
Name of parent/guardian (in case of minor participant) ___________________________________
Passport (nationality / number) ______________________________________________________
Signature __________________________________ Date _______________________________
Email _____________________________________ Phone ______________________________