CONTRACTUAL ASSUMPTION ACKNOWLEDGEMENT OF RISKS AND LIABILITY WAIVER AND RELEASE AGREEMENT
IN CONSIDERATION of being permitted to participate in the charter/rental provided by Magen Berry for myself and/or any minor children for whom I am the legal parent/guardian or otherwise responsible, and for my/our heirs, personal representatives, or assigns:
i Insured’s name will be the name as detailed on the policy including any DBA names. I.e. Fred Smith DBA Freddie’s Fishing Trips. ii Participants must initial each section throughout the document. iii This will include the name of the Charter/Rental if it has one. i.e. Freddie’s Fish Adventures if there is no name Charter/Rental can remain. iv This is the country as detailed on the policy. v Assured’s name will be the name as detailed on the policy including any DBA names. I.e. Fred Smith DBA Freddie’s Fishing Trips. vi Please state the court, for your locality e.g. Circuit in and for Miami-Dade County Florida/Western District of New York. vii Insured’s name will be the name as detailed on the policy including any DBA names. I.e. Fred Smith DBA Freddie’s Fishing Trips. viii Each and every participant must sign and initial the release and complete the details. One document for each participant. ix If a participant is below 18 years of age a parent/guardian must complete the details.