SUMMARY DOCUMENT

Please read and acknowledge your understanding back on the registration form. We will have you sign the actual form once you arrive at training.

Acknowledgement of Risk and Release of Liability for Training / Certification (v.3 Update 10-2017)

I, the undersigned, in consideration of my participation in this training (hereinafter referred to as the “Training”) offered by Andrews Consulting, LLC d.b.a. Northwest Teambuilding (“NW Teambuilding”), do hereby expressly acknowledge, accept and agree to the following:   

Acknowledgment of Risks.  I acknowledge that participation in Training involves a variety of challenging activities that may include (but is not limited to) warm ups, games, problem solving activities, group experiences, high and low challenge course elements, climbing walls trees and/or poles, stretching, running, jumping, lifting, supporting and being supported by other participants, and opportunities for participants to share feelings and emotions. I understand that these activities may take place outside, in all weather conditions and all times of the year. I fully accept that these activities have an inherent risk of serious physical injury, emotional stress, and/or death, resulting from falling off course elements (or other participants falling), overexertion, mechanical or equipment failures, natural and weather related conditions and all other expected and unexpected ways in which people may be hurt when engaging in physical activities.

Participation by Personal Choice.  I hereby accept the above described risks (and any other unforeseeable risks) and choose to participate in the Training. I acknowledge my participation in the Training is entirely voluntary, and that I may stop participating at any time during the Training for any reason. I understand that I will be responsible for making decisions (whether or not specifically asked) on my own level of capabilities and comfort performing any activity. I accept that NW Teambuilding has not evaluated my physical or mental fitness, is under no obligation to make any such evaluation, and that it is my personal responsibility to decline to participate in any activity that I do not believe I am capable of, or do not wish, to perform. I agree to listen carefully to safety briefings given during the Training and make appropriate decisions about my involvement. I acknowledge that following staff instructions does not eliminate the risk of injury or death. 

Good Health.  I affirm that my health is good and that I am not aware of any condition that could bear upon my physical or mental fitness to participate in Training. 

Release from Liability. I hereby forever release, discharge, and waive all claims, suits or other demands for damages against NW Teambuilding, its employees and agents, arising from or related to my participation in the Training, except as caused by the sole gross negligence of NW Teambuilding, its employees or agents.

Publicity Release.  I consent to the use of my image, likeness and voice as captured in still photographs, and/or audiovisual recordings made during the Training for promotional purposes of NW Teambuilding, including placement on NW Teambuilding’s website and other marketing or training materials. Yes, initial here /  No, initial here.

Acknowledged, accepted and agreed on this ____ day of _____________________, 20____.                                         

Print Name                                                                                             Sign Name

Email                                                                                                    Mobile/Telephone