I _______________________________________________________ have heard the standard RIVER SAFETY LECTURE, delivered by _________________________________________

At _______________________________________________ on (date) ___________________ at __________________ (a.m. / p.m.)

By my mark, I agree that I have head the points below discussed, that my questions have been adequately answered, and that I understand the points made: (Initials please)

_____ River running is a recreational endeavor with some risk. While rafting is generally conducted safely, some accidents do occur. I may be involved in such an accident and this lecture is to help me prepare to react appropriately.

_____ I have / haven’t (circle one) been drinking or using controlled drugs in the last three hours. I understand the dangers of alcohol and drugs for river trip passenger.

I understand the following river terms:

_____ River right and river left

_____ Eddies

_____ Holes

_____ Rocks, logs, and the command "High Side"

_____ Strainers, sawyers, and debris piles

_____ I understand that if I find myself swimming I should immediately put my feet downstream and get over on my back, knees bent and heels lower than my buttocks to protect my lower back

_____ I understand that when swimming I should concentrate on breathing in the troughs of the waves and exhale in the crests, trying to keep my head turned slightly to the side.

_____ I understand the dangers of a lower leg injury or catching my feet in rocks if I attempt to stand up in the rapids, and that I should wait for a calm spot, after swimming to the bank in a backstroke, before attempting to stand up.

_____ I understand that if I am thrown from the boat I should assume the sitting position with my feet downstream until pulled on board again

_____ I understand that if the boat overturns that the safest place to be is either alongside or completely away from the boat, so that downstream boats and rescuers can reach me.

_____ I understand that if I am unavoidably swimming into a strainer or debris pile I should attempt to turn over and swim into it in a crawl-type stroke as strongly as possible, with my head downstream, either climbing on top or over the obstacle-all in order to avoid entrapping myself.

_____ I understand the hazards of attempting to rescue another passenger who is swimming and in trouble.

I am aware of the following hazards:

_____ Slippery rocks on and near the water’s edge

_____ Diving off of the banks of the river

_____ Loose oars on oar frame boats

_____ Natural hazards such as poison oak, snake, nettles, etc.

I understand the basic whistle and arm signals, particularly:

_____ One arm in the air means, "Help me!"

_____ One whistle blast means, someone is trying to get our attention

_____ Arms making an "O" shape over the head means, "I am OK."

_____ Boatman pointing to river right or left means, "swim in this direction."

_____ I understand that my personal flotation device should be worn at all times while I am on the water and that I should adjust it so that I can get a full breath, but also so that when I fully exhale it will not slip up over my head.

_____ I understand that the opportunity may be offered to me, if the boatmen feel it is advisable due to weather and water conditions, to make a short swim, so that I can practice the basic swimming position. If the boatmen and trip leaders feel such a swim is not necessary, they have explained why not to my full understanding.

(Complete below only if optional swim is offered)

_____ I have been offered an opportunity to make a short, optional swim.

_____ I have / have not (circle one) elected to do so, and this was my own decision.

By my witnessed signature below I hereby agree that I have head all the material above, as indicated by my initials, that all my questions have been answered satisfactorily, and that I still wish to make the river trip starting this date, despite the risks as explained to me above.

Signed ________________________________ Date, Time, Place _____________________

Witness _______________________________ Date, Time, Place _____________________

In consideration of being permitted to participate in any way in the rafting activity I for myself, my personal representatives, assigns, heirs, and next of kin:

1. Acknowledge, agree and represent that I understand the nature of rafting activities and that I am in good health, and in proper physical condition to participate in such activity. I further acknowledge that the activity will be conducted over public rivers, roads and facilities open to the public during the activity and upon which hazards of traveling are to be expected. I further agree and warrant that if at any time I believe conditions to be unsafe; I will immediately discontinue further participation in the rafting activity.
2. I fully understand that (a) rafting activities involve risks and dangers of serious bodily injury, including permanent disability, paralysis and death (risks); (b) these risks and dangers my be caused by my own actions, or inaction’s, the actions or inaction’s of others participating in the rafting activity, the condition in which the rafting activity takes place, or the negligence of the "releases" named below; (c) there may be other risks and social and economic losses either not known to me or not really foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation in the rafting activity.
3. Hereby release, discharge, and convenient not to sue the operators, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the rafting activities take place, (each considered one of the "releases" herein (from all liability, claims, demands losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the "releases" or otherwise, including negligent rescue operations, and I further agree that if, despite the release and waiver of liability, assumption of risk, and indemnity agreement I, or anyone on my behalf, makes a claim against any of the "releases", I will indemnify, save, and hold harmless each of the releases from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.
4. I understand this release is intended to discharge and release, in advance, the rafting operators, its members and their respective agents and employees from and against any and all liability arising out of or connected in any way with my participation in the event even thought that liability may arise out of negligence or carelessness on the part of the persons or entities associated with the rafting operator.
5. I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability of the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

Signed ________________________________ Date, Time, Place _____________________

Witness________________________________ Date, Time, Place _____________________