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2019 Eagle Island

Release and Waiver of Liability

& Photo Release

Contact Information
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First Name
Last Name
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Release and Waiver of Liability

I, the undersigned, intend to participate in an Eagle Island activity at Eagle Island. I understand that there are inherent risks involved during this visit, and on behalf of myself and my family members, heirs and assigns, hereby voluntarily agree to release, waive and forever discharge and hold harmless Eagle Island, Inc., its staff, employees, officers, directors, and volunteers from any and all liability, claims and demands of whatever kind or nature, either in law or in equity, for any injury, illness, loss, wrongful death, or damage to person or property that may occur during the course of my involvement, whether caused in whole or in part by the negligence or other conduct of Eagle Island, Inc., its staff, employees, officers, directors, or volunteers.

I UNDERSTAND the nature of the activity may include potentially hazardous activities and environments, including, without limitation, the following:

  • There is no professional medical personnel on the site. The nearest hospital is at least a half hour drive from the mainland landing.

  • The location of the camp is a true wilderness site which includes natural hazards such as a wilderness lake which is not fenced or gated, many acres/miles of wild forest, wildlife, uneven terrain, unpredictable weather, the possibility of tree or limb falls, as well as other hazards that are inherent to the wilderness environment. There are also man-made structures and improvements on the property in varying states of repair and disrepair, which may create hazards.

  • There are no lifeguards on duty at the lake.

  • No training or professional supervision is being provided.

I ALSO AGREE:  to follow the rules and regulations governing tranportion to the Island and activities on the Island, as may be posted and/or provided in some other form.  Without limiting the contents of such rules and regulations, I understand that:

  • NO FIREWORKS of any kind are to be on or used on the island
  • SMOKING is NOT permitted on the ISLAND or on the BOATS   (except in ONE very limited area on the island)  

I HEREBY EXPRESSLY AND SPECIFICALLY: assume the risk of injury, death or harm in these activities and release Eagle Island, Inc., its staff, employees, officers, directors, and volunteers from all liability for injury, illness, death, or property damage resulting from such activities.

I expressly agree that this Release and Waiver is intended to be as broad and inclusive as permitted by the laws of the State of New York, and that this release shall be governed by and interpreted in accordance with the laws of the State of New York. I agree that in the event that any clause or provision in this Release and Waiver shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clauses or provision shall not otherwise affect the remaining provisions of this Release and Waiver, which shall continue to be enforceable.


A separate form is required for each adult! Please separate names of minors with commas.
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Photo Release Form

I hereby authorize Eagle Island to publish the photographs taken of me, and my name, for use in printed publications and website. I acknowledge that since my participation in publications and websites produced by Eagle Island is voluntary, I will receive no financial compensation. I further agree that my participation in any publication and website produced by Eagle Island confers upon me no rights of ownership to the organization whatsoever. I release Eagle Island, its contractors and its employees from liability for any claims by me or any third party in connection with my participation.

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By entering your name and today's date below, you are submitting an electronic signature for this consent form.

 

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First Name
Last Name
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