HEALTH DECLARATION AND RISK ACKNOWLEDGEMENT

1.     I acknowledge that the Activities provided by Exewake Limited require a reasonable level of fitness and ability.  For children under 16 years of age, I confirm that they are confident in deep water whilst wearing a buoyancy aid. 

2.     I further acknowledge that I am responsible for my own safety and the safety of others whilst partaking in the Activities. I agree to follow all safety instructions (both written and verbal) and I will comply with any instructions given at any time by staff members.  Any child under 16 who attends a session without an adult and does not follow safety instructions will be refused participation in the activities. 

3.     I warrant that I will only carry out moves and tricks that are within my ability level. Moves and tricks are performed at my own risk.

4.     I understand that a buoyancy aid is provided for safety and I agree to ensure they are worn and will be fastened at all times whilst taking part in the Activities or in the water.

5.     In the event of an accident or any damage, loss, injury or death I acknowledge that Exewake Limited will not be liable for any direct or indirect loss, damage or injury arising from or in connection with the Activities (except for death or personal injury caused by Exewake Limited’s negligence) and I waive all and any claims against Exewake Limited in this respect both for myself and for the children in my care.

6.     I certify that to the best of my knowledge I do not have a medical condition which might make me more likely to sustain an injury.

7.     I understand that participation in the Activities provided by Exewake Limited entail known and unknown risks that could result in physical or emotional injury, paralysis, death or damage to myself to property or to third parties.

8.     I will not take part in an Activity whilst under the adverse influence of drink or drugs.

9.     I strongly agree and promise to accept all risk existing and subsisting in the Activities and acknowledge that all participation in the Activities is voluntary and that I wish to participate despite the risks.

10.  I release and agree to indemnify Exewake Limited, together with their equipment suppliers and manufacturers, from all claims demands or courses of action that are in any way connected with my participation in the Activities.

11.  I declare that I have authority to sign this risk acknowledgement and disclaimer on behalf of all those participating in my group.

Name (adult) *
Name (adult)
Child one *
Child one
Child two
Child two
Child three
Child three
I certify that I have read, fully understand and accept all terms of the foregoing statement. *
Please specify if photographs can be taken of you, or a minor in your care.
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We respect your privacy.   Should you have any questions or concerns about this form, please contact us on info@exewake.co.uk or call 07825539450.