Liability Waiver Form

Please sign before your scheduled surf lesson

Date: ______________

Phone: 808-636-7873

Website: FlaglerSurfSchool.com

Liability Release Form for Flagler Surf School

In consideration of being allowed to participate in any of Flagler Surf School’s programs and / or related activities. I, ______________________________ (print full name) acknowledge and fully agree to the following disclosures: 1. Risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist. 2. I Acknowledge That Surfing May Be Dangerous And I Accept And Assume Such Risks, both known and unknown, EVEN IF ARISING FROM THE NEGLEGENCE OF THE RELEASEES or others, and assume full responsibility for my participation: I am aware that open water activities in general, and surfing specifically, involves inherent risks. 3. I willingly agree to release Flagler Surf School, Flagler County County Beaches, and the City of Saint Augustine, or any of its employees from responsibility and waive all my rights to take any legal action against them. If I observe any unusual or significant hazards during my presence or participation in this activity, I understand that it is my responsibility to remove myself from participating and bring such to the attention of the nearest official immediately. 4. I Waive My Right To Sue Flagler Surf School, Flagler County Beaches, and the City of Saint Augustine: In consideration for Flagler Surf School agreeing to provide me with surfing instructions and allowing me to participate in this class or lesson, I agree that I shall not make a claim or bring any action against, sue, or hold responsible, Flagler County County Beaches, the City of Saint Augustine, and Flagler Surf School, its owners, officers, agents, employees, associates, representatives, (referred to collectively in this agreement as “Flagler Surf School”) or expect, require, or pursue them, to be held accountable for any damages. I voluntarily agree to release, discharge, and hold harmless Flagler Surf School from and against any and all claims of liability, even those arising out of their negligence, fault, recklessness, or any other act or omission which causes me damages, illness, injury, disease, or death, of any nature in any way connected with my participation in this activity. I also expressly agree to release and discharge Flagler Surf School from any act or omission, excluding acts of wanton or gross negligence, in rendering or failing to render any type of rescue, emergency or medical services. 5. Promotional Use of Images: I hereby agree that Flagler Surf School may use film or photographic records of this surfing class or lesson for its promotional and/or commercial purposes without compensation to me, and I consent to the use of my name and likeness for such use in any media now known or not known. 6. I agree to replace and / or compensate for all or any equipment damaged due to my negligence. 7. I, for myself and on behalf of my heirs assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS, Flagler Surf School, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasee”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damages to personal property, WHETHER ARISING FROM THE NEGLEGENCE OF THE RELEASEE OR OTHERWISE, to the fullest extent permitted by the law. 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 VOLUNTARY WITHOUT ANY INDUCEMENT. Name & Signature: ________________________________________________________________________ Email & Phone: ________________________________________________________________________________ Initial Here: [________] If You Have Read & Agree To Flagler Surf School’s Policy (www.flaglersurfschool.com/policy) Below: If You Are Signing For Participant Under 18 Years Old As A Parent Or Guardian. Name of Minor/s: ___________________________________________________________________ This is to certify that, as parent of guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasee, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Flagler Surf School and affiliates from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Parent/Guardian’s Name & Signature: ______________________________________________________