Acknowledgement of Risk and Consent to Care

In consideration of the services of their officers, agents, employees,  and stockholders, and all other persons or entities associated with those businesses (hereafter collectively referred to as “GirlVentures”) I agree as follows:  

Awareness and Assumption of Risk I understand that activities in GirlVentures’ programs have inherent risks that may arise from the activities themselves, my own actions or inactions, or the actions or inactions of GirlVentures, its directors, officers, employees and agents, volunteers, and others present at GirlVentures program sites, or conditions at program sites. 

Certain risks are inherent in each activity.  These inherent risks are some of the same elements that contribute to the unique character of this activity and can be the cause of loss or damage to my equipment, or accidental injury, illness, or in extreme  cases, permanent trauma or death. GirlVentures does not want to frighten me or reduce my enthusiasm for this  activity, but believes it is important for me to know in advance what to expect and to be informed of the  inherent risks. The following describes some, but not all, of those risks.  

These risks may include, but are not limited to: transportation, failure or malfunction of equipment, exposure to elements, high altitude and extreme weather and related injuries including frostbite, heat exhaustion, heat stroke, sunburn, hypothermia, hyperthermia and dehydration; rock falls, falling trees, avalanches or lightning strikes; crossing or climbing rock, snow or ice; river crossings, rapids, impacting the water, water intrusion, fording or portaging; falls, uneven terrain and other outdoor risks; injury to limbs and extremities, including inflammation, strains, nerve damage, compression and broken bones; attack by insects, reptiles or other wild animals; contact with poisonous plants; discharge of weapons in or near the area of activity; or loss of balance, physical coordination, or ability to follow instructions.

I understand the description of these inherent risks is not complete and that other unknown or unanticipated  inherent risks may result in injury or death. I agree to assume and accept full responsibility for the inherent risks identified herein and those inherent risks not specifically identified, regardless of cause. My participation in this activity is purely voluntary; no one is forcing me to participate, and I elect to participate in spite of and with full knowledge of the  inherent risks.  

I acknowledge that engaging in this activity may require a degree of skill and knowledge different from other activities and that I have responsibilities as a participant.  For my safety and that of others, I agree to comply with GirlVentures’ policies, safety rules and other directions for all activities. If I become aware of any hazardous condition or danger at a GirlVentures program site, I will alert GirlVentures staff at once.

I certify that I am fully capable of participating in this activity. Therefore, I assume and accept full responsibility for myself, including all minor children in my care, custody, and control, for bodily injury, death, or loss of  personal property and expenses as a result of those inherent risks and dangers identified herein and those  inherent risks and dangers not specifically identified, and as a result of my negligence in participating in this  activity.  

I have carefully read, clearly understood, and accepted the terms and conditions stated herein and acknowledge  that this agreement shall be effective and binding upon me, my heirs, assigns, personal representative, and estate  and for all members of my family, including minor children.  

Confidentiality At GirlVentures, I may have access to confidential information. At all times during and after my participation, I agree to hold any such confidential information in confidence and not disclose or use it except as required in my GirlVentures activities or as GirlVentures’ executive director expressly authorizes in writing.

Publicity I consent to the use by GirlVentures of my image, voice, name and/or story in any format, including video, print, or electronic (collectively, the “Materials”), as GirlVentures may deem appropriate to carry out its mission. GirlVentures may make the Materials available at its discretion to third parties, on GirlVentures’ website, in GirlVentures’ publications, or through any other media, including social networking websites. I waive any right to inspect or approve the finished product or to receive any payment. I grant GirlVentures all copyrights in the Materials and waive any legal claims, including those relating to copyrights, or rights of publicity or privacy.

Medical Care Consent I authorize GirlVentures to provide first aid, and, through medical personnel of its choice, medical assistance, transportation and emergency medical services. This consent does not impose a duty upon GirlVentures to provide such assistance, transportation, or services. In addition, I waive and release any claims against the Released Parties arising out of any first aid, treatment or medical service, including the lack of timing of such, made in connection with my activities with GirlVentures.