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Kayaking at Kent Park with Johnson County Conservation
Participant Waiver of Responsibility Form – Kayaking
Understand that kayaking can be dangerous
(Required)
I, the undersigned, by participating in, Kayaking at Kent Park with Johnson County Conservation sponsored by Coralville Public Library’s Teen Summer Reading Program, understand and agree that such activity has certain inherent risks that can and do result in injury that can be serious, life limiting, and life threatening.
(Required)
City employees and volunteers are not responsibly for injuries
(Required)
I, the undersigned, agree to release the Coralville Public Library and the City of Coralville, its elected officials, employees or volunteers from all claims resulting from any and all injuries sustained while participating in the Kayaking program, except that arising out of the sole negligence of the Coralville Public Library or the City of Coralville, its elected officials, employees or volunteers.
(Required)
Responsible for own transportion to event
(Required)
I, the undersigned, know that I am responsible for providing my own transportation to and from Kent Park.
(Required)
I have read and consent to all above information
(Required)
I, the undersigned, have read the accompanying information in the event description and will comply with all rules set by the Johnson County naturalists and the library staff.
(Required)
Name of Participant
(Required)
First
Last
Participant Signature
(Required)
Date signed
(Required)
MM slash DD slash YYYY
If Participant is a minor (under the age of 18), a parent or legal guardian must sign this form.
Name of Parent / Legal Guardian
First
Last
Phone number where parent / legal guardian can be reached during this event
Signature of Parent / Legal Guardian
Date signed
MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.
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