Canoe and Brew to The Land Where the Five Mountains Meet 09.16.17
First Name *
Last Name *
How many in your party? *
Will you be renting a boat from our illustrious outfitter?
Yes. (Please contact outfitter directly at 570-885-0081.)
No, I have my own boat.
Will you need a shuttle to the launch site? *(Leave your car at river end, and shuttle back to river beginning for launch.)
Yes. (Please contact the outfitter at 570-885-0081.)
No, I'll shuttle myself.
If you want a shuttle, how many people are you shuttling?
Would you like to purchase a delicious sandwich from SAC Lunches?
If YES, let us know which one and how many! Moroccan Chicken is $8.00 (w/ Forks Chicken), and Lemon Hummus Pesto Wrap is $7.00 (Gib's Farm Veggies) - pay on Saturday - cash only.
CANOE AND BREW WAIVER AND RELEASE OF LIABILITY * I agree as follows: I fully understand and acknowledge that outdoor recreational activities have: (a) inherent risks, dangers and hazards and such exists in my participation in Canoe and Brew activities; (b) my participation in such activities and/or use of borrowed equipment may result in injury or illness including, but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of the organizers or agents of Canoe and Brew, the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. Risks and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, guide decision making, including that a guide may misjudge terrain, weather, trail or river route location, and water level, risks of falling out of or drowning while in a raft, canoe or kayak and such other risks, hazards and dangers that are integral to recreational activities that take place in a wilderness, outdoor or recreational environment; and (d) by my participation in these activities and/or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of the organizers or agents of Canoe and Brew or by any other person. I, on behalf of myself, my personal representatives and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Canoe and Brew and its organizers and agents from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my use of outdoor equipment or my participation in rafting, kayaking, camping or canoeing activities. I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the organizers or agents of Canoe and Brew. The Venue of any dispute that may arise out of this agreement or otherwise between the parties to which the Canoe and Brew.or its agents is a party shall be in Columbia or Montour Counties. I HAVE READ THE ABOVE AGREEMENT, WAIVER AND RELEASE AND BY SIGNING IT AGREE. IT IS MY INTENTION TO EXEMPT AND RELIEVE ALL ORGANIZERS OR AGENTS OF CANOE AND BREW FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. I WILL WEAR PERSONAL FLOATATION DEVICE WHILE BOATING!
I agree (all paddlers must sign waiver and release of liability.)
I verify I am 18 years old or older. *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service