Learning Goals and Special Requests What do you want to learn, see, do? Please let us know if you have any special requests. Any accommodations required?
Medical Issues/History So that our staff can a) accommodate your needs, and b) assist you in the event of an emergency, please describe any present medical issues or past medical history.
PARTICIPANT RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT In consideration of being allowed to participate in any way in an activity with Colorado Backcountry LLC (also doing business as Backcountry Bike Academy), including all related events and transport to and from the activities, I the undersigned, acknowledge, appreciate, and agree that:
1.(Required) 1. The risk of injury from the activities involved in this program is significant during all phases of the activity, including the potential for permanent paralysis, disability and death. These risks include but are not limited to: a) Cold weather and heat related injuries and illnesses including frostnip; frostbite; heat exhaustion; heat stroke; altitude sickness; hypothermia and, dehydration; b) “acts of nature” which may include rock fall; landslides; avalanches; inclement weather; thunder and lightning; severe and/or varied wind; temperatures; fire; flood; earthquake; and other weather or environmental hazards; c) River crossings; d) Travel to, during and from activities by motorized or mechanized means not limited to automobiles, helicopters, bicycles, snowmobiles, skis, snowshoes e) Risk associated with mountain activities (e.g. skiing; hiking; crossing, climbing or down-climbing of rock, snow and/or ice) not limited to loose, slippery or falling rock; avalanches; cornices; cliffs; treewells; snow covered objects; hazardous snow conditions; falling on or through ice; or immersion in deep snow or water; f) Equipment maintenance, failure and/or operator error; g) Tripping, slipping, falling, my sense of balance, physical coordination, physical abilities and/or limitations; and my ability to follow instructions; h) Attack by or encounter with insects, reptiles, and/or wild or domestic animals; i) Accidents or illnesses occurring in remote places where there are no available medical facilities; j) Fatigue, chill, and/or dizziness, which may diminish reaction time and increase the risk of an accident or injury; and k) The availability and proficiency levels of backcountry rescue and medical treatment.
I acknowledge the description of these risks is not complete and that unknown or unanticipated risks may result in property damages, personal injuries, illness, or death. I agree to wear and use as instructed any necessary safety equipment. I recognize that failure to do so increases the potential for severe injury or death and absolves the RELEASEES from any liability whatsoever.
I Agree(Required)
6.(Required) 6. By participating in or attending any activity in connection with this program, whether on or off the premises, I consent to the use of any photographs, pictures, film or videotape taken of me or my child/ward or provided by me for publicity, promotion, television, websites or any other use and expressly waive any right of privacy, compensation, copyright or other ownership right connected to same.
I Agree(Required)
7.(Required) 7. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the COLORADO BACKCOUNTRY LLC, its officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the program (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any INJURY, DISABILITY OR DEATH I may suffer, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I Agree(Required)
8.(Required) 8. DISEASE AMENDMENT (updated March 2024): Acquiring communicable diseases is an inherent risk that exists in any public place where people are present. By participating in Colorado Backcountry programs, I voluntarily assume all risks related to exposure to any communicable diseases. I acknowledge that I will not participate if I experience am knowingly sick and expect that I might transfer a disease to others. I recognize public health orders may change and I will abide by revised policies for guided trips as necessary. I acknowledge that my failure to do so will lead to not being able to continue with Colorado Backcountry activities. Current (March 2024) practices include:
-If requested by Colorado Backcountry staff or other participants, I will wear face coverings or space myself from others,
-I will wash my hands and/or using hand sanitizer before participating,
-I will respect the choices of others around me to use more stringent health protection measures if they wish,
-I will cough/sneeze into my elbow,
-I will practice good hygiene.
I Agree(Required)
Electronic Signature Consent(Required) By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no psecial hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no panalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
I Agree
Electronic Signature Consent(Required) By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no psecial hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no panalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
I Agree