The Handi-Boat Society of Alberta
WAIVER FORM
GROUP NAME ______________________________________________
ADDRESS ______________________________________________
CONTACT PERSON ___________________________________________
PHONE NUMBER ____________________________________________
DATE of VOYAGE ____________________________________________
WAIVER - 2012
In consideration of the Handi-Boat Society, agreeing to accept the undersigned as participant(s) in its alternative recreation program, for travel on its pontoon boat on the above date(s) [or alternate(s)] him/her or his/her legal guardian hereby agrees and covenants for him/herself and for his/her respective heirs, legal representatives and assigns to irrevocably bind him/herself from making claim or demand or to commence, cause or permit to be prosecuted any action in law or equity against The Handi-Boat Society of Alberta or any of its Directors, Employees, Sponsors, Servants, Agents or Subcontractors on account of any personal injury, failure to offer medical treatment, negligently applying medical treatment, disability, property damage, loss of services, expenses or any other damages of any kind that the below signed may sustain as a result of carriage on any craft of The Handi-Boat Society of Alberta.
PARTICIPANT NAME [print] PARTICIPANT SIGNATURE
______________________________ _________________________
GUARDIAN NAME [print] GUARDIAN SIGNATURE
______________________________ __________________________
Date: ________________
Information 