Standard Waiver and Exclusion Agreement
In consideration of being permitted to participate in a hot air balloon ride (hereinafter "the flight") conducted by the Air Display Hot Air Balloon Team of Rolland Enterprises Inc. (hereinafter "the company"),
I,
Name: _____________________________________ Birth Year:______
Street (RR#):______________________________________________
City (Town): ______________________ Province (State): ____________
Country:_____________________Postal Code (ZIP): _______________
Phone:_____________________________
E-Mail:___________________________________________________
agree and acknowledge the following:
The purpose of the flight in which I am about to participate is exclusively recreation and that neither the company nor any of its agents, employees or servants (hereafter collectively called "representatives") has undertaken any duty to instruct or educate in the pilotage or safe operation of hot air balloons or given to me any undertakings, guarantees, warranties or representations whatsoever as to the safety of or any other matters pertaining to the flight.
I understand any fees paid to the company or its representatives are for the balloon flight only.
I understand and agree that all photographs taken during the flight may be used to promote hot air ballooning without any further permissions and at the discretion of the company.
I shall obey all directions and instructions given to me by the company or its representatives before, during and after the flight. That due to weather or wind conditions or any other reason within the sole discretion of the company or its representatives, the flight may be canceled or may not be able to begin or end at or on the time or date scheduled.
I voluntarily assume any and all risks whatsoever involved in taking the flight, which risks may arise before, during or after the flight including travel to or from the location of the flight on either public or privately owned lands.
I am in good health and physically fit to undertake the flight and that if I am in doubt, I will advise the company and its representatives and seek appropriate medical advice.
I hereby release and forever discharge the company, its representatives and successors from all liability and responsibility for any injury, loss or damages suffered by me or my property before, during and after the flight for any reasons whatsoever, including any act of negligence or omission on the part of the company or its representatives.
That this agreement shall endure to the benefit of the company and its representatives, successors and assigns and shall be binding on me and my heirs, executors, administrators and assigns.
I have read the above and understand it and that I am entering into this Standard Waiver and Liability Exclusion Agreement of my own free will and not under duress.
Signature of Passenger:__________________________________Date:___________
If the above passenger is under the age of eighteen (18) years, the following shall also be executed by his or her parent or legal guardian whether he/she or they accompany the minor on the flight or not.
I,
Parent or Guardian (print):___________________________________________________
have read the above and understand the above Standard Waiver and Liability Exclusion Agreement which has been executed by:
Name of Minor (print):____________________________________________________ and as Parent or legal Guardian of said minor, agree to the signing thereof and permit said minor to take the flight offered by the company on the terms and conditions set forth therein.
Signature of Parent or Guardian:____________________________________________________
Witness
(print and initial):____________________________________________