| To speed up the process, we now have an information form and release form available on-line for you to print off and fill out information before your scheduled lesson or surf camp. These forms are required for participation in Ocean Isle Surf Academy activities. Thank you!! |
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LAST NAME ___________________________ FIRST NAME____________________________
ADDRESS ___________________________________________________________________
CITY ______________________________ STATE ______________ ZIP__________________
VACATION PHONE _________________________ CELL ______________________________
E-MAIL _________________________________________________ AGE ________________
PLEASE CHECK THOSE THAT APPLY:
O PRIVATE LESSON ($40 FOR 1 HOUR LESSON)
O GROUP LESSON ($35 PER PERSON FOR 1 HOUR LESSON)
O SURF CAMP
LIST EXTRA FAMILY MEMBERS FOR SURFING LESSONS, OR SURF CAMP
___________________ ____________________ ___________________ ______________
___________________ ____________________ ___________________ ______________
PLEASE SPECIFY AND MEDICAL CONDITIONS WE NEED TO BE AWARE OF
(i.e. HEART CONDITIONS, ASTHMA, NECK OR BACK PROBLEMS, SHUNT, HEAD INJURY,
VERTIGO, RECENT ILLNESS) LIST IN SPACE BELOW:
___________________________________________________________________________
___________________________________________________________________________
Participant Agreement, Release, and Assumption of Risk:
In consideration of the services of Ocean Isle Surf Academy, their owners, officers, volunteers, participants,
employees, and all other persons or entities acting on their behalf (herein collectively referred to as Surf Academy), I
hereby agree to release, indemnify, and discharge Surf Academy, on behalf of myself, my children, my parents, my
heirs, assigns, personal representatives, and estate as follows:
1. I acknowledge that surfing entails known and unanticipated risks which could result in physical or emotional injury,
paralysis, death, or damage to myself, to property, or to third parties. I understand that suck risks simply can not be
eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: being hit
by the board, other surfers or their boards, which could result in cuts, bruises, abrasions, or concussions: hitting the
bottom of the ocean; sprains, strains, broken bones, paralysis, or even death; exhaustion, dehydration, sunburn;
exposure to poisonous and/or carnivorous sea creatures; and accidental drowning. Furthermore, Surf Academy
instructors have difficult jobs to perform. They seek safety, but are not infalIible. They might be unaware of a
participant's fitness or abilities. They might misjudge the weather, the elements, or the terrain. They might give
inadequate warnings or instructions, and equipment being used might malfunction.
2. I expressly agree and promise to accept and assume all risks existing in this activity. My participation in this activity
is purely voluntary, and I elect to participate in spite of the risks. I understand that should I become disruptive to the
program, rude or abusive to the Surf Academy staff or other participants, create discomfort for other participants, or
discard safety standards, I will be asked to leave without compensation. Surf Academy reserves the right to refuse
service to anyone.
3. I hereby voluntarily release, forever discharge and agree to indemnify and hold harmless Surf Academy from any
and all claims, demands, or causes of action, which are in any way connected to my participation in this activity, or my
use of Surf Academy equipment, including any such claims which allege negligent acts of admission of Surf
Academy.
4. Should Surf Academy or anyone acting on their behalf, be required to incur attorneys fees and costs to enforce this
agreement, I agree to indemnify and hold them harmless for all such fees and costs.
5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or
else I agree to bear the cost of such damage or injury myself. I further certify that I am willing to assume the risk of
any medical or physical condition I may have.
6. In the event I file a lawsuit against Surf Academy, I agree to do so solely in the state of North Carolina, and I further
agree to the substantive law of that state shall apply in the action without regard to the conflict of laws of that state. I
agree that if any portion of this agreement is found to be void or unenforceable the remaining portion shall remain in
full force and effect.
7. I understand weather, water, and surf conditions are beyond the control of Surf Academy and it's agents. Other
natural elements such as reptiles, rodents, insects, and microorganisms such as bacteria and viruses are also an
inherent risk on a Surf Academy safari, and are not grounds for refund.
8. I understand that from time to time, photographers may take photos of guests for use in promotional materials
such as web sites, advertisements, catalogues, and magazine editorials. I do not expect any compensation for such
use. If I do not want my photograph taken I will notify a representative of Surf Academy.
By signing this document, I acknowledge that if anyone is hurt or property is damaged by my participation in this
activity, I may be found by a court of law to have my right to maintain a lawsuit against Surf Academy on the basis of
any claim from which I have released them from herein.
I have had sufficient opportunity to read this entire document. I have read and understood it and agree to be bound by
it's terms.
Signature of Participant _______________________ Print Name ______________________ Date _____________
PARENT'S OR GUARDIAN'S EXTRA INDEMNIFICATION (MUST BE COMPLETED OF PARTICIPANT IS UNDER 18)
In consideration of _________________________ (print minor's name) being permitted by Surf Academy to
participate in its' activities, and to use its' equipment, I further agree to indemnify and hold harmless Surf Academy
from any and all claims which are brought by or on behalf of minor, and which are in any way connected with such
use or participation by minor.
Signature of Parent or Guardian ______________________ Print Name ___________________ Date___________
OCEAN ISLE SURF ACADEMY 322 TRUXTON STREET KILL DEVIL HILLS, NC 27948 910-352-6579