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BACKWATER GUIDE SERVICE

ALL PATRONS of Backwater Guide Service must complete the waiver form before the beginning of any fishing.

I hereby acknowledge that participating in fishing activities presents a risk of personal injury, death and damage or loss of personal property which may result from, but is not limited to the following: fishing and/or wading in or around lakes, ponds, reservoirs or other bodies of water, boarding and un-boarding of watercrafts, natural hazards including, but not limited to lightning storms and other adverse weather conditions; domestic or wild animals; fire; travel either on foot or in a vehicle in unfamiliar terrain or over fences and other structures, artificial and natural obstructions and unimproved roads, the consumption of provisioned or other food and beverages as well as traveling in company owned vehicles.

I hereby acknowledge and recognize the existence of these risks, and ASSUME ALL RISKS COMPLETELY, and agree that I SHALL HOLD HARMLESS AND TAKE NO ACTIONS OR SUITS, FOR DEBTS, DUES, SUMS OF MONEY, CLAIMS OR DEMANDS WHATSOEVER AT LAW OR IN EQUITY AGAINST Backwater Guide Service, Gary W Clancy or Katrina M Clancy , his or her heirs, executors, assigns, administrators, property or other guides or aides for injury, death, property damage or loss associated with relating to or arising from those risks enumerated above or otherwise that occur while I am participating in any stage of a fishing package trip(s) with Backwater Guide Service.

I understand and acknowledge that by signing this document that I have given up certain legal rights and/or possible claims which I might otherwise assert or maintain against Gary W Clancy or Katrina M Clancy, Backwater Guide Service. These rights are specifically, but not limited to, rights arising from claims or demands for acts of omissions or negligence in any degree of Backwater Guide Service, their guides, aides and all other related persons or entities. Under no circumstances will Backwater Guide Service, Gary W Clancy or Katrina M Clancy, be held liable for damages in excess of the price of the trip.

I understand that this contract reflects our entire agreement and that my signature indicates that I have read and understand this document and that I have signed this document of my own free will.

I understand that this waiver applies to any and all trips I participate in with Backwater Guide Service, and its owners, agents, officers and employees. I further state that I am of lawful age to sign this release and waiver agreement or that I am signing it on behalf of a minor for whom I legally responsible.

If signing for a minor please sign again below.

Signature__________________________________ Date: ___________________

I hereby give consent that my child/children or minor for whom I am legally responsible as here listed participate in a guided trip Backwater Guide Service. And I hereby execute the above Agreement, Wavier, and Release on his/her behalf. I hereby agree to hold Backwater Guide Service, and its owners, agents, officers and employees, and any other persons or entities mentioned above free and harmless from any loss, liability, damage, cost or expense which they may incur as a result of death or any injury or property damage that said minor may sustain while participating in said activity.

Minors Name: _____________________________ Relationship: _______________

Parent/Guardian ______________________________ Date: __________________