Cabrinha Quest Medical and Liability Release Form
Must be filled in BEFORE boarding Discovery
FULL NAME AND ADDRESS *
Your answer
Date of Birth *
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YYYY
Email Address *
Your answer
Medical History
Please answer all questions. Enter Comments if necessary for any 'yes' answers, or have your physician send us a summary.
Do you have any Disease, or is any other drug or treatment being prescribed which should be continued or periodically evaluated? (give details)
Your answer
Do you have any drug allergy or any other known sensitivity or intolerance such as to insect bites, foods, pollens? (give details )
Your answer
Have you had any SERIOUS injury, illness, operation, or been hospitalized? (give details)
Your answer
Do you take any regular medication(s)? If so, please remember to bring double your usual amount, in two protected locations, in case one gets lost or destroyed. (give details)
Your answer
Do you have any special dietary needs (not covered on the application)? *
Your answer
Please tell us what kind of foods or drinks you like, need, or would like to have on board? *
Any special requests?
Your answer
Person to notify in case of emergency: *
Your answer
Relationship: *
Your answer
Emergency Contact details *
Please provide phone, email, address of emergency contact
Your answer
Name of Health Insurance Company
Your answer
Policy Number
Your answer
ACKNOWLEDGEMENT OF SWIMMING ABILITY
Falling overboard while underway is an unlikely, but real possibility. Your ability to swim in open ocean water is crucial to your survival during a man overboard rescue situation. By signing this document, you hereby acknowledge that you can comfortably swim: 1. At least 50 yards in moderate open ocean water. 2. You can tread water for at least 15 minutes in moderate open ocean water.
OR: 3. In the event that I am a non-swimmer, I agree to wear a Personal Flotation Device when on deck and underway. (This is a requirement for all persons under 12 years old, unless under the supervision of a parent)
Initial here *
Your answer
PHOTO RELEASE and MODEL RELEASE
I hereby agree to give any employee of Offshore Odysseys, GoPro, Patagonia and/or Cabrinha Kites the use of photos or video tape footage of me in books, articles, catalogs, television programs or brochures without compensation. I understand that if modeling fees are available, the manufacturer or distributor will pay them directly to me.
Initial here *
Your answer
EQUIPMENT USE POLICY
Watersports including kitesurfing and surfing are HAZARDOUS and there is an INHERENT RISK of injury associated with their practice. We expect all participant guests to totally familiarize themselves with all warnings, instructions, user manuals and guidelines for any such equipment that is provided on board including any safety systems, and to agree to follow them. If you have any questions or uncertainties regarding the appropriate setup and use of such equipment, you should obtain advice and direction from the Ocean Odyssey crew prior to using it.

Furthermore, we expect your personal conduct when practicing these sports to be exemplary. This means you must always follow all warnings, instructions, and user manuals and any recommended practice, guidelines and requirements of any facility or location in which the equipment is being used. This includes participating in these sporting activities only within all marked boundaries and/or open areas. You should become familiar with and follow any relevant sporting activity/location Responsibility Codes, rules or regulations. By setting a good example, you will encourage others to do the same.

I have read, understand and agree to follow the Ocean Odyssey Equipment Use Policy as set out above.

Initial here *
Your answer
Release of Liability, Agreement to Hold Harmless and Indemnify, and Assumption of Risk.
Completion of this form is required for each person joining The Cabrinha Quest. Please read carefully before signing. By signing this Agreement, each person participating in an expedition waives all claims against Gavin McClurg, and the Crew of The Cabrinha Quest, d/b/a Offshore Odysseys Inc, and any reservation/booking agent for injury, accident, illness or death during or by reason of their joining a passage on the sailing vessel Discovery. You must have an outbound ticket from port of disembarkation.

I DO HEREBY ACKNOWLEDGE that I am aware that during the trip in which I will be participating, certain risks and dangers may arise, including but not limited to, the hazards of traveling on the open sea, falling overboard, storms, high winds, collision of vessels, shipwreck, travel ashore in remote terrain, the forces of nature, and accident or illness in remote regions without means of rapid evacuation or medical facilities. I am also aware and clearly understand that Gavin McClurg, and his Crew d/b/a Offshore Odysseys will have no liability regarding provision of medical care or the adequacy of any care that may be rendered. In consideration of the Agreement with Offshore Odysseys to participate in this expedition, I hereby agree that I will assume all risk of this trip and I will not make any claims against Offshore Odysseys or sue for bodily injury, emotional trauma, death and/or property damage resulting from negligence or unseaworthiness of the vessel, or other acts, however caused, as a result of my participation in this trip. I, therefore, release, indemnify and discharge Offshore Odysseys, Gavin McClurg, and its booking agents and employees from all claims, actions and demands that I may have for bodily injury, death or property damage arising from my participation in the trip.

Initial here *
Your answer
This RELEASE OF LIABILITY, AGREEMENT TO HOLD HARMLESS AND INDEMNIFY, AND ASSUMPTION OF RISK
Agreement is entered into on behalf of all members of my family, including any minors accompanying me. If any person who accompanies me on this trip as part of my family or friends makes claim, or if a claim is made on their behalf, I or my estate will indemnify and hold harmless Offshore Odysseys Inc., Gavin McClurg, from any loss, including reasonable attorney's fees incurred in the defense of such claim. This Agreement is binding upon my heirs, legal representative and assigns. If any portion of this Agreement is unenforceable, the remaining portions shall remain in full force and effect. All applicants are subject to acceptance by Offshore Odysseys. This Agreement shall be deemed to have been entered into at Nevis., and shall be construed and interpreted according to the laws of the Nation of Nevis. In the unlikely event a legal dispute should arise, I agree the dispute shall exclusively be brought before the appropriate court in the Nation of Nevis. I have carefully read this Agreement of RELEASE OF LIABILITY, AGREEMENT TO HOLD HARMLESS AND INDEMNIFY, AND ASSUMPTION OF RISK, and understand its terms. I execute it voluntarily and with full knowledge of its significance.
Initial here *
Your answer
SIgnature and Date: *
Please add your initials and today's date before sending. A copy of this form will be provided to you when you board for signature.
Your answer
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