Golden and Silver Falls, Saturday April 16
Sign Up Form for Heceta Head
Sign in to Google to save your progress. Learn more
Email *
Name *
Are you interested in being a hike leader?
Clear selection
Number in party. *
Name (s) of other hiker(s)
Mobile Phone Number, in case we need to contact you during the hike.
Optional--Emergency Contact Name and phone number
South Coast StridersHike Request Form and Release from Liability, Assumption of Risk, and COVID-19 Considerations
I am aware that South Coast Strider activities like the one I am signing up for are potentially dangerous, that accidents can happen, and that illness can occur in remote places.

In consideration of being permitted to join and participate in this South Coast Striders activity, I do for myself, my heirs, legal representatives, and assigns (or, if applicable, as a parent or legal guardian of a minor), assume all risks associated with this activity and traveling to and from the activity, and release and discharge the South Coast Striders, their officers, volunteers and sponsors from all liability for any and all loss, damage or claim on account of property damage, death or bodily injury to me, my minor child or minors for whom I am legal guardian, caused by the act or failure to act of the South Coast Striders, their officers, volunteers, agents or sponsors.

I hereby certify that I am in good physical and mental condition and am able to safely participate in this activity. I hereby consent to receive emergency medical treatment, at my own expense, which may be deemed necessary in the event of injury, accident or illness during this event. I will additionally permit the use of my name and pictures in broadcasts, telecasts, newspapers, websites, brochures, etc.


COVID-19 Considerations on hikes:

Hikers will be asked to maintain social distance on the trail

Hikers should step off the trail to let others pass
REQUIRED----I have read and understood the Release of Liability, Assumption of Risk, and COVID-19 considerations and agree to the terms: (note--this form can't be submitted unless you agree). *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy