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PARTICIPANT RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

Organization Name:   LAKE SAMMAMISH PADDLE CO. (“Company”)

Participant Name:                                                                      Telephone:                                                           

In consideration of being allowed to participate in any way in the paddle, kayak, boating, and similar programs, related events, rentals and activities (collectively, “Activities”), I the undersigned, acknowledge, appreciate, and agree to all the terms and conditions set forth in this instrument (“Release”):

1. The risk of injury from the Activities is significant, including the potential for personal or psychological injury, pain, suffering, disability, permanent paralysis death and/or financial loss.

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE ORDINARY NEGLIGENCE OF THE COMPANY OR ANY OTHER RELEASEES (defined below) or others, and assume full responsibility for my participation.

3. I willingly agree to comply with terms and conditions for If I observe any unusual significant hazard during my presence or participation, I will remove myself bring it to the attention of the nearest official immediately.

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY EXPRESSLY WAIVE AND RELEASE COMPANY AND WASHINGTON STATE PARKS its officers, agents and/or employees, volunteers, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (COLLECTIVELY, “RELEASEES”), from any and all claims, demands, and liability arising out of or related to any INJURY, DISABILITY OR DEATH arising out of the Activity or my participation in the Activity that I may suffer, or loss or damage to person or property, WHETHER ARISING FROM THE ORDINARY NEGLIGENCE OF THE COMPANY OR ANY OTHER RELEASEES OR OTHERWISE to the fullest extent permitted by I agree not to make or bring any such claim against the Company or any other Releasee, and forever release and discharge the Company and all other Releasees from liability under such claims. This waiver does not apply to claims for gross negligence, willful misconduct, or other liabilities that Washington law does not permit to be released.

5. I shall DEFEND, INDEMNIFY, AND HOLD HARMLESS COMPANY AND ALL OTHER RELEASEES against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, costs, or expenses of whatever kind, including attorney fees, and the cost of pursuing any insurance providers arising out or resulting from any claim of a third party related to my participation in the Activity, including any claim related to my own negligence or the ordinary negligence of the Company or any other Releasees.

6. PLEASE BE RESPECTFUL of PRIVATE PROPERTY by staying off of neighboring docks and beaches.

7. This Release is the entire agreement between the parties. If any provision of this Release found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. This Release is binding on successors and assigns. Any dispute arising under this agreement shall be governed by Washington law and heard only in the state or federal courts of King County, Washington.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

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Participant’s Signature                                                                                           Age                         Date

FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of the Company and all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Company and Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE ORDINARY NEGLIGENCE OF THE COMPANY OR ANY OTHER RELEASEES, to the fullest extent permitted by law.

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Parent/Guardian Signature                                                                      Date           Emergency Phone Number(s)