Agreement Declaration and Exemption from Responsibility

SPORT ACTIVITY______PROGRESSIVE NUMBER______

AGREEMENT DECLARATION AND EXEMPTION FROM RESPONSIBILITY

Referring to the river descent that I have decidet to make with the Sporting Association “Centro Canoa Rafting Monrosa” based in via Roma, 1 Balmuccia (VC):

1) first of all I declare to be able to swim and to be physically and mentally fit. 2) I also declare that I have been warned by the organizing body about the difficulties and the dangers related to this sport activity, including the possibility of falling in the water. I intende to participate on my own risk declaring that I have been technically instructed and I have been informed about the norms of behaviour that I have to conform to in case of emergency. 3) I aknowledge that the specific equipment required by both I.C.F. (International Canoe Federation) and by the A.I.Raf. (Italian Rafting Association) self regulation rules that are shown on the notice board available at the nautical base has been given to me. 4) I exempt the “Centro Canoa Rafting Monrosa” and his guides from any responsibility and indemnity for the physical or material damages that may take place before, during or after the river descent, even if attributable to third parties or to other participants, the only exception being the case of evident malicious intent or serious fault. 5) I have been fully informed about the content of this declaration that I have carefully read and subscribed by my own free initiative. 6) I request to be associated to the “Centro Canoa Rafting Monrosa” as member …………..for the year …………To this end I declare to have read the statute and the rules of the Sporting Center and to accept entirely all the norms governing its activities.

To be filled up by the person in charge of a child or minor (write in Block Letters and clearly):

I ______

ID number: ______

AUTHORIZED MY SON/DAUGHTER ______TO PARTICIPATE ON THE WHITE WATER ACTIVITY ORGANIZED BY THE CENTRO CANOA RAFTING MONROSA.

Balmuccia (VC), date of the activity______

SIGNATURE OF THE PERSON IN CHARGE

______

Child or minor reference

Name______surname______

Date of Birth______place of Birth______

Resident in______street______n°______

Zip code______town______country______Tel.______e- mail______

I agree to treatment of my personal data by the CENTRO CANOA RAFTING MONROSA for purposes related to offered services, according to the law31/12/1996 n° 675 and following modifications, signature______