IMPORTANT: THIS IS A LEGAL DOCUMENT
Please read and understand this document before signing. If you have any questions please ask us or consult an attorney.
Navy Morale, Welfare and Recreation (MWR) Department U.S. Naval Support Activity, Naples, Italy and its staff have done everything possible to assure that our patrons experience a rewarding experience. We wish to inform our patrons that whitewater rafting is not risk free. The same elements that contribute to the unique character and fun of whitewater rafting such as physical exertion or rapids can cause loss or damage to equipment, and injury, illness, or in extreme cases, permanent trauma or death to myself or others under my supervision. We do not want to heighten or reduce your enthusiasm for the experience, but we do want you to know in advance what to expect, and to be informed of some of the possible risks. We ask that you read, sign, and return this document to our office.

RAFTING ACKNOWLEDGMENT OF RISK

(1)  There are numerous rapids to be encountered on the trip.  Passengers can be jolted, jarred, bounced, thrown about, and otherwise shaken during rides through some of these rapids.  It is possible that passengers could be injured if they come in contact with food boxes, other storage containers, other passengers, or other fixed equipment necessary to the operation of the expedition and the outfitting of the raft.
(2)  Boats may turn over in the rapids, which may result in any or all of the following events:  (a)  prolonged exposure to cold water leading to hypothermia and to impaired health or death;  (b)  injuries sustained from the raft and its supplies and/or equipment during the turn over or after the passenger is in the water, or from items floating in the river or in the river bed, such as floating debris or rocks; (c)  death by drowning;
(3)  Participants can be "washed" overboard in the rapids, which can result in any of the above events occurring:
(4)  Accidents can occur during off-river excursions: (a)  trails are often steep, rocky, and/or slippery;  (b)  some hikes involve crossing streams, where footing can be awkward;  (c)  participants can slip or fall during a hike, resulting in injury or death; (d)  poisonous or dangerous plants, insects, or animals can be encountered, with detrimental effects to some participants, such as illness, shock, or death.
(5)  Accidents can occur getting on and off the raft:  (a)  rafts are sometimes slippery when wet.  You might slip and fall, in which case you might damage or lose equipment you are carrying (such as cameras, glasses, a canteen or day pack), or you might injure yourself by falling against some object in or on the boat, or on the shore.  (b)  rafts get hot in the sun,  you might burn yourself when you climb aboard or sit on the side of the raft.  (c)  rafts may drift a distance from the shoreline when you are trying to climb on or off, you might fall in the river, or drop equipment in the river.  (d)  you may be asked to help push the boat from shore into deeper water.  You could injure your back, over-stress your heart, or otherwise injure yourself in doing so.  (e)  you may be asked to help with tying the raft when you pull into shore.  Sometimes the current is swift, and the rope could pull through your hands causing "rope burns" or abrasions. (f) you might trip over rocks, stumps or other debris on shore while trying to hold the raft or tie it to a suitable object on shore.
(6)  Accidents can occur during travel to and from the activity site. Trails are often steep, rocky, and slippery. Hikes involve crossing streams, where footing can be awkward. Participants can slip or fall during a hike, resulting in injury. Poisonous or dangerous plants, insects, or animals can be found with harmful effects to some guests.  Exposure to the natural elements can be uncomfortable or harmful.  Heat-sunburn, dehydration, heat exhaustion, heat stroke, heat cramps, wind, rain, outdoor, using portable toilet facilities, eating meals out-of-doors, being in the open for the extended length of the trip can be uncomfortable or cause injury.
As part of the Rafting trip, Navy MWR Department U.S. Naval Support Activity, Naples, Italy may provide transportation by motor vehicle, van, or bus to and from the starting and ending point.  In that event, I understand and agree that I cannot hold U.S. Naval Support Activity, Naples, Italy liable for any injury I received due to the transportation Navy MWR Department U.S. Naval Support Activity, Naples, Italy provides.  Accidents occur during travel to and from the starting and ending point of the trip over the roads and highway.  I agree that terms of this release shall cover any injury I receive due to an accident on the part of Navy MWR Department U.S. Naval Support Activity, Naples, Italy whether by their negligence or the negligence of others.
The list of possible accidents stated above may inflict bodily injury, disease, strains, fractures, partial and/or total paralysis, other ailments that could cause serious disability or death.  It is also possible that some participants would suffer mental anguish or trauma from the experience or their injuries.
This list is not an exclusive or exhaustive list of possible injuries, trauma or accidents that may occur while rafting.  Most of these injuries are rare and you are not likely to encounter them.  However, they have occurred, and you need to know about them and other possible injuries not mentioned above. These injuries occur more often when the participants are using drugs or alcohol or not physically able to undertake the activity.

CONTRACT, WAIVER, RELEASE AND INDEMNIFICATION
I certify that my family, including minor children, and myself are fully capable of participating in a rafting trip/program or activity. I state that I have read the above statement on some of the possible risks in the rafting trip/program or activity. Therefore, I assume full responsibility for myself, my family, including minor children, for bodily injury, death and loss of personal property and any expenses as a result of my negligence, negligence of my family, negligence of another participant on the trip, or the negligence of Navy MWR Department U.S. Naval Support Activity, Naples, Italy and its staff. I also understand that Navy MWR Department U.S. Naval Support Activity, Naples, Italy reserves the right to refuse any person it judges to be incapable of meeting the rigors and requirements of participating in the rafting trip/program or activity.  My family and I are in good physical condition and able to undertake this activity.  I agree to indemnify and hold harmless Navy MWR, Navy MWR Department U.S. Naval Support Activity, Naples, Italy, U.S. Naval Support Activity, Naples, Italy and its staff, and the U.S. Navy, and its members, agents and employees from all claims, damages, losses, injuries and expenses arising out of or resulting from my families or my participation in the rafting trip/program or activity. I further agree to release, acquit and covenant not to sue Navy MWR, Navy MWR Department U.S. Naval Support Activity, Naples, Italy, U.S. Naval Support Activity, Naples, Italy and its staff, and the U.S. Navy, and its members, agents and employees for all actions, causes of action claims or damages, damages in law or remedies in equity of whatever kind, including the negligence of Navy MWR Department U.S. Naval Support Activity, Naples, Italy and its staff, or my family, myself, or my heirs, against Navy MWR Department U.S. Naval Support Activity, Naples, Italy arising out of participation in the rafting trip/program or activity. In short, I cannot sue Navy MWR, Navy MWR Department U.S. Naval Support Activity, Naples, Italy, U.S. Naval Support Activity, Naples, Italy and its staff, and the U.S. Navy, and its members, agents and employees, and if I do, I cannot collect any money.
       I agree to the site of any lawsuit and the law governing any such lawsuit shall be governed under the Federal Tort Claims Act, Military Claims Act, Foreign Claims Act, Suits in Admiralty Act, Public Vessels Act or Admiralty Extension Act, which ever is applicable.  The terms of this agreement shall continue and be in effect after the rafting trip/program or activity has ended.
As liquidated damages, I hereby agree that if Navy MWR Department U.S. Naval Support Activity, Naples, Italy is forced to defend any action, lawsuit or litigation by myself, my executors, or my heirs, on my family's or my behalf; accordingly, my heirs or executors and I agree to pay court costs and attorney fees if they successfully defend such action, lawsuit or litigation. 
Should any paragraph or part of this agreement be declared unenforceable by a court of competent jurisdiction, the remaining parts or paragraphs shall remain in full force and effect.  A copy of this release can be used as if it was an original.
I authorize and release to Navy MWR Department U.S. Naval Support Activity, Naples, Italy and its staff the use of my image in any photograph or video recording for any purpose of Navy MWR Department U.S. Naval Support Activity, Naples, Italy.
I have adequate health, disability and life insurance for my family and myself.
I hereby give permission for transportation to any medical facility or hospital, and I authorize any guide, or medical personnel to render necessary emergency medical care for my family or me.  I hereby authorize the release of any medical information, including information concerning my HIV or “AIDS” status, in the possession of Navy MWR Department U.S. Naval Support Activity, Naples, Italy to any medical facility, hospital, ambulance, first aid provider, first aid service, doctor, nurse or other such person rendering care on my behalf.  I hereby waive any action or claim against Navy MWR Department U.S. Naval Support Activity, Naples, Italy and its staff or any health care provider, hospital, doctor, nurse or first aid provider for the release of this medical information including my HIV or “AIDS” status.

I, _________________________________________________, of my own free will, for my family, my minor children, my heirs and executors and myself, have read, understand and acknowledge the risks and liability for myself, and my family this _______ day of ___________________________ 2015.
[__]	By checking this box, I indicate that my family and I have previous ________________ experience.
[__]	No one in my family or I have any medical condition that would prevent our participation in this activity except: ___________________________________________.
I have read and understood this agreement.
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FIRST PARTICIPANT SIGNATURE		SECOND PARTICIPANT SIGNATURE
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PRINTED NAME		PRINTED NAME
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ADDRESS		THIRD PARTICIPANT SIGNATURE
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PHONE:[_____]_____________________________            _________________________________________
IN CASE OF EMERGENCY PLEASE CONTACT: _______________________________________________
PHONE: 	
I CARRY MEDICAL INSURANCE. YES _____ NO _____ GROUP NUMBER: ________________________
NAME OF PROVIDER: _____________________________________________________________________