Field Trip Waiver, Release, and Assumption of Risk

[LRC_Admin]

Field trip location: _________________________________________

Field trip date(s): _________________________________________

Trip leader: _______________________________________________

Participant Information
Full name: _______________________________________________

Address: _________________________________________________

Phone: _________________________________________________

Email: __________________________________________________

Emergency contact: _______________________________________

Relationship: ____________________________________________

Emergency phone: ________________________________________

Acknowledgment of Risks
I understand that participating in a Longmont Rockhounding Club field trip to collect or observe rocks, minerals, fossils, gemstones, and related specimens involves inherent and potentially serious risks.

These risks may include, but are not limited to:

Uneven, steep, unstable, or slippery terrain
Falling rocks, rockslides, loose soil, and unstable slopes
Cuts, punctures, bruises, sprains, fractures, or other injuries
Hand tools, hammers, chisels, digging equipment, and flying rock fragments
Abandoned mines, shafts, tunnels, cliffs, caves, and other hazardous features
Extreme heat, cold, wind, lightning, snow, rain, dehydration, or altitude sickness
Wildlife, insects, plants, and exposure to natural hazards
Vehicle travel, remote locations, rough roads, and delayed emergency assistance
Lost or separated participants
Damage to personal vehicles, tools, equipment, or specimens
Risks caused by my own actions or the actions of other participants
I understand that emergency medical services may be distant or delayed and that participation may require walking, hiking, climbing, bending, lifting, digging, or carrying equipment and specimens.

Assumption of Risk
I voluntarily choose to participate in this field trip and knowingly assume all risks, whether known or unknown, ordinary or extraordinary, associated with participation, travel connected with the activity, collecting, handling specimens, and being present at the field location.

I certify that I am physically able to participate or have informed the trip leader of any condition that may affect my safety. I agree to carry and use any medications, medical devices, protective equipment, water, food, clothing, and supplies appropriate for my needs.

Agreement to Follow Rules
I agree to:

Follow the Club’s charter, bylaws, rules, field-trip procedures, safety instructions, and responsible-collecting policies.
Follow all instructions given by the trip leader or designated Club representative.
Use the Club’s buddy system and remain with my assigned buddy or group.
Not collect alone, leave the designated area, or separate from the group without permission.
Use tools and protective equipment responsibly.
Respect private property, active claims, public-land regulations, closures, permits, collecting limits, cultural resources, wildlife, and the environment.
Obtain permission before entering or collecting on private property.
Avoid abandoned mines, shafts, cliffs, unstable slopes, and other prohibited or dangerous areas.
Immediately report an injury, emergency, unsafe condition, lost person, or property damage.
Stop participating if directed by the trip leader for safety, legal, weather, or conduct reasons.
Avoid behavior that endangers myself or another person.
Release and Waiver
To the fullest extent permitted by applicable law, I release and agree not to sue the Longmont Rockhounding Club, its officers, directors, members, volunteers, trip leaders, agents, representatives, affiliated organizations, landowners, property managers, and activity sponsors—the “Released Parties”—for claims arising from my participation in or travel associated with this field trip.

This release includes claims for personal injury, illness, death, property damage, loss of specimens, or other loss arising from the ordinary negligence of a Released Party, to the extent such a release is permitted by law.

This agreement does not release claims that cannot legally be waived, including claims arising from gross negligence, reckless conduct, intentional misconduct, or other liability that applicable law does not permit the parties to release.

Indemnification
To the fullest extent permitted by applicable law, I agree to reimburse and hold harmless the Released Parties from claims, losses, damages, costs, or expenses—including reasonable legal expenses—arising from:

My negligent, reckless, or intentional conduct;
My violation of law, property restrictions, or Club rules;
Damage I cause to property; or
Claims brought by another person because of my actions.
Medical Treatment Authorization
If I am injured or become ill and cannot provide informed consent, I authorize the trip leader or another Club representative to seek reasonable emergency assistance for me, including contacting emergency services and arranging transportation for medical evaluation.

I understand that I am responsible for my own medical expenses, transportation costs, medications, and treatment expenses.

The Club is not required to provide medical care or emergency transportation.

Personal Property
I understand that I am responsible for my own vehicle, tools, equipment, clothing, specimens, and personal belongings. The Club is not responsible for loss, theft, or damage to personal property except where responsibility cannot legally be waived.

Photographs and Media
Please select one:

☐ I authorize the Club to use photographs or video of me taken during Club activities for noncommercial Club purposes, including newsletters, educational materials, social media, and the Club website.

☐ I do not authorize the Club to use photographs or video of me.

This permission does not authorize the use of my name or personal information unless separately approved.

Participant Certification
I certify that:

I have read this entire document.
I understand the risks of the field trip.
I understand that this is a legal agreement.
I have had the opportunity to ask questions before signing.
I am signing voluntarily.
The information I provided is accurate.
I agree to be bound by this waiver and release.
Participant signature: ______________________________________

Printed name: ___________________________________________

Date: __________________________________________________

Parent or Legal Guardian Consent for a Minor
Minor’s name: ____________________________________________

I am the parent or legal guardian of the minor named above. I have read and understand this agreement, including the risks, rules, release, assumption of risk, and medical-treatment provisions. I give permission for the minor to participate in the field trip.

To the fullest extent permitted by applicable law, I agree to the terms of this agreement on behalf of myself and the minor. I also agree to be responsible for the minor’s conduct and for claims arising from the minor’s actions, to the extent permitted by law.

Parent/guardian name: ____________________________________

Relationship: ____________________________________________

Signature: ______________________________________________

Date: __________________________________________________

Emergency and Special Information
Allergies: _______________________________________________

Medical conditions relevant to participation:

Medications or emergency needs:

Mobility or accessibility needs:

Preferred hospital or medical provider, if applicable:

Club Use Only
Waiver received by: _______________________________________

Date received: ___________________________________________

Participant accepted by trip leader: ☐ Yes ☐ No

Notes: __________________________________________________