Tippy-Canoe Rentals, Inc.

Liability Release and Rental Responsibilities

I_________________________, regardless of whether or not, separate, joint,

or concurrent liability may be imposed upon Theresa T. Pence and / or Robin R. Solomon and / or Tippy-Canoe Rentals, Inc. , shall hereby release and hold harmless Theresa T. Pence and / or Robin R. Solomon and / or Tippy-Canoe Rentals, Inc. from any and all liability for accident, damage or injury caused to my person or property on or about the premises of Theresa T. Pence, Robin R. Solomon and / or Tippy-Canoe Rentals, Inc., or while on any canoe trip or other guided or unguided outing, whether due to negligence on the part of Theresa T. Pence and / or Robin R. Solomon and / or Tippy-Canoe Rentals, Inc., and not withstanding whether such acts or omissions be active or passive. 

   I understand that each canoe is equipped with two (2) paddles and two (1) life jacket per person and that I am responsible for any damages to or replacement cost for the canoe, paddles, and life jackets.

 I understand that if I consume alcoholic beverages while out on a canoe trip or at the premises of Theresa T Pence, Robin R. Solomon, and / or Tippy­Canoe Rentals, Inc. , that I am assuming the risks involved and agree to hold harmless Theresa T. Pence, Robin R. Solomon and / or Tippy-Canoe Rentals, Inc. from any liability.

 I understand that there may be further rules and regulations that I must follow established by Tippy-Canoe Rentals, Inc., that may be posted or orally related to me. I agree to abide by these rules and regulations and understand that if I fail to do so that I will be asked to remove myself and my possessions from the premises.

 I acknowledge that the signing of this liability release was my own free and voluntary act and I understand that I am giving up some of my legal rights and privileges in doing so.

Dated this____________day of_______________________, 20__

_________________________________        ________________________________

_________________________________        Signature of Parent or Guardian

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Signature and address