Acknowledgment of Water Sentinels Participant Responsibility, Express Assumption of Risk, and Liability Release Risk, and Release of Liability

I understand that during my participation in the Sierra Club Water Sentinels program, I may be exposed to a variety of hazards and risks, foreseen or unforeseen, which are inherent in water sampling and litter cleanup in and around rivers, creeks, streams, and other water bodies and which cannot be eliminated.  These inherent risks include, but are not limited to, the dangers of serious personal injury, property damage, and death (“Injuries and Damages”) during travel to and from the activity, or from rough terrain, slippery rocks, steep slopes, deep water, poison oak and ivy, snakes, tool use, debris, and possible water pollution, and the Sierra Club has not tried to contradict or minimize my understanding of these risks.  I know that Injuries and Damages can occur by natural causes or activities of other persons or animals, either as a result of negligence or because of other reasons.  I understand that risks of such Injuries and Damages are involved in water sampling and litter cleanup and I appreciate that I may have to exercise extra care for my own person and for others around me in the face of such hazards.  I further understand that during my participation in these Water Sentinels activities there may not be rescue or medical facilities or expertise necessary to deal with the Injuries and Damages to which I may be exposed.

In consideration for my acceptance as a participant in the Sierra Club Water Sentinels program, I confirm my understanding that:

· I am responsible for evaluating my own physical abilities and limitations in participating in Water Sentinels activities, and I acknowledge that my participation in Water Sentinels activities is at the discretion of the Water Sentinels Leader.

· I always will ask permission before entering or crossing private property when participating in Water Sentinel activities. 

· This Agreement is intended to be as broad and inclusive as is permitted by law.  If any provision or any part of any provision of this Agreement is held to be invalid or legally unenforceable for any reason, the remainder of this Agreement shall not be affected thereby and shall remain valid and fully enforceable.

· To the fullest extent allowed by law, I agree to WAIVE, DISCHARGE CLAIMS, AND RELEASE FROM LIABILITY the Sierra Club, its officers, directors, employees, agents, and leaders from any and all liability on account of, or  in any way resulting from Injuries and Damages, even if caused by negligence of the Sierra Club its officers, directors, employees, agents, and leaders, in any way connected with my participation in Water Sentinels activities.  I further agree to HOLD HARMLESS the Sierra Club, its officers, directors, employees, agents, and leaders from any claims, damages, injuries or losses caused by my negligence while a participant in Water Sentinels activities.  I understand and intend that this assumption of risk and release is binding upon my heirs, executors, administrators and assigns, and includes any minors accompanying me on Water Sentinel activities.

· I have read this document in its entirety and I freely and voluntarily assume all risks of such Injuries and Damages and notwithstanding such risks, I agree to participate in Water Sentinels activities.

Name:               ________________________________________

Signed:                                     Date:   

If you are a minor (under age 18), your parent or legal guardian must sign this Agreement on your behalf.

I hereby agree and consent to the foregoing Agreement  on behalf of the minor below.

Name and Age of Minor:

                                                (Please Print)                                                                                        (Age)

Signature of Parent or Guardian:              Date:   

Please complete and return this form to your Water Sentinel Leader prior to participation in any water sampling or litter cleanup activities.