Lupine Collective Waiver Form

HEALTH HISTORY

PHOTO/VIDEO RELEASE

EMERGENCY CONTACT INFORMATION

RELEASE OF LIABILITY AND ASSUMPTION OF RISK

I, the undersigned individual, desire to participate in one or more outdoor adventure programs, including without limitation mountain biking courses or clinics, retreats, or other events, workshops, activities or programs (collectively, the "Activities") provided, offered or sponsored by Lupine Collective (a project of Maine Outdoor Kids, LLC, a Maine limited liability Company) with offices located at 315 Portland Rd., Gray, ME 04039 ("Lupine"). In consideration of being permitted by Lupine to participate in the Activities and in recognition of Lupine's reliance hereon, I agree to all the terms and conditions set forth in this legally binding instrument (this "Release").

I hereby make the following warranties and representation with respect to my participation in the Activities:

1. I am physically and mentally capable of attendance and participation in the enrolled Activities and associated equipment.

2. I will comply with all recommended safety precautions, instructions, and procedures.

3. I will equip myself with the recommended gear and clothing for my participation in the Activities. 

4. If I have any questions about the Activities or whether I am physically or mentally capable of participating, it is my sole responsibility to do whatever research or inquiry is necessary to make that determination. 

5. I acknowledge that Activities occur outdoors and that there are inherent risks that may be involved and understand that changes in location or schedule, or cancellations, may occur due to inclement weather.

6. I understand and agree that any and all equipment that I will use in the course of participation in the Activities supplied by me shall be in good working order for the duration of the Activity. I understand that any mechanical failure, including but not limited to popped tubes/tires on bikes, may result in my inability to participate.

7. I understand and agree that Lupine expressly reserves the right to withdraw my registration from, or expel me from, any Activity based on my own improper behavior, conduct or use of equipment, with the sole and final determination of the same being the responsibility of Lupine.

8. I have fully informed Lupine of all known allergies and medical conditions that may affect my participation in the Activities. I further acknowledge that it is my responsibility to update Lupine regarding any changes to my medical status prior to participating in any Activities.

   
   

I AM AWARE AND UNDERSTAND THAT THE ACTIVITIES ARE POTENTIALLY DANGEROUS ACTIVITIES TO ME AND INVOLVE THE RISK OF PERSONAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, DEATH, PROPERTY DAMAGE, AND/OR FINANCIAL LOSS. I ACKNOWLEDGE THAT ANY INJURIES THAT I MAY SUSTAIN MAY RESULT FROM OR BE COMPOUNDED BY THE ACTIONS, OMISSIONS, OR NEGLIGENCE OF LUPINE, INCLUDING NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF LUPINE. NOTWITHSTANDING THE RISK, I ACKNOWLEDGE THAT I AM KNOWINGLY AND VOLUNTARILY PARTICIPATING IN THE ACTIVITIES WITH AN EXPRESS UNDERSTANDING OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DISABILITY, DEATH, AND/OR PROPERTY DAMAGE ARISING FROM MY PARTICIPATION IN THE ACTIVITIES, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF LUPINE OR OTHERWISE.

I hereby expressly waive and release any and all claims, now known or hereafter known, against Lupine, and its members, managers, employees, agents, instructors, coaches, volunteers, successors, and assigns (collectively, "Releasees"), on account of injury, disability, death, or property damage arising out of or attributable to my participation in the Activities, whether arising out of the ordinary negligence of Lupine or any Releasees or otherwise. I covenant not to make or bring any such claim against Lupine or any other Releasee, and forever release and discharge Lupine and all other Releasees from liability under such claims. This waiver and release does not extend to claims for gross negligence, willful misconduct, or any other liabilities that Maine law does not permit to be released by agreement.

I shall defend, indemnify, and hold harmless Lupine and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorney fees, fees, the costs of enforcing any right to indemnification under this Release, 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 Activities. 

I hereby consent to receiving medical treatment deemed necessary if I am injured or I require medical attention during participation in the Activities. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation. I hereby release, forever discharge, and hold harmless Lupine from any claim based on such treatment or other medical services.

This Release constitutes the sole and entire agreement of Lupine and I with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Release is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or invalidate or render unenforceable such term or provision in any other jurisdiction. This Release is binding on and shall insure to the benefit of Lupine and I and our respective heirs, successors, and assigns. All matters arising out of or relating to this Release shall be governed by and construed in accordance with the internal laws of the State of Maine without giving effect to any choice or conflict of law provision or rule (whether of the State of Maine or any other jurisdiction). Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in Cumberland County, Maine and I hereby consent to the exclusive jurisdiction of such courts.

BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE LUPINE. I ACKNOWLEDGE THAT PRIOR TO SIGNING THIS AGREEMENT, I HAD THE OPPORTUNITY TO CONSULT WITH AN ATTORNEY TO REVIEW THIS AGREEMENT. I AM AT LEAST EIGHTEEN (18) YEARS OF AGE AND FULLY COMPETENT.