Fishing Academy Waiver Form

Block Island Fishing Academy Activity Release of Liability In exchange for participation in the activity of the Block Island Fishing Academy, and use of the properties, facilities and services associated with the Fishing Academy, I agree for myself and (if applicable) for the members of my family to the following: I agree to observe and obey all posted rules and warning, and further agree to follow any oral instruction or directions given employees, representatives or agents of the Fishing Academy I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge the Fishing Academy for injury, loss or damages arising out of my or my family's use of or presence upon the facilities, whether caused by the fault of myself, my family, the Fishing Academy or other third parties. I agree that images and/or videos taken during sessions may be used by the Fishing Academy for publicity purposes without payment of any fee. I further agree to pay for all damages to the property and facilities of associated with the Fishing Academy caused by me or my family's negligent, reckless, or willful actions. I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS

Child #1 Name:(Required)

First Last

Child #1 Age:(Required)

Children must be 6 years old and up to participate in the Fishing Academy.

Please enter a number greater than or equal to 6.

Do you have additional children to add?(Required)

Yes

Child #2 Name: (If Applicable)

First Last

Child #2 Age: (If Applicable)

Children must be 6 years old and up to participate in the Fishing Academy.

Please enter a number greater than or equal to 6.

Child #3 Name: (If Applicable)

First Last

Child #3 Age: (If Applicable)

Children must be 6 years old and up to participate in the Fishing Academy.

Please enter a number greater than or equal to 6.

Name of Parent or Guardian:(Required)

First Last

Signature of Parent or Guardian:(Required)

Entering your name in this field is equivalent to a legal written signature.

Today's Date:(Required)

Please enter today's date.

Phone Number:(Required)

Email Address:(Required)

Would you like to be added to our email list?

Yes