I ASSUME ALL RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES carried out by Green Baker Lodge in Puerto Bertrand and locations indicated for the activities, including by way of example and without limitation, any risk that may arise due to negligence or carelessness on the part of released persons or entities, for dangerous or defective equipment or goods owned, maintained or controlled by them, or for their possible liability without fault.

I CERTIFY that I am in good physical shape, that I have sufficient preparation or training to participate in this activity and that I have not been recommended by a qualified medical professional not to participate.

I CERTIFY that there are no health-related reasons or problems that prevent my participation in this activity.

I acknowledge that this Accident Waiver and Liability Waiver Form will be used by the owners, sponsors and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities in such activity.

In consideration of my request and allowing me to participate in this activity, I hereby make provisions for myself, my executors, administrators, heirs, next of kin, successors assigning as follows:

• (1) I WAIVE, RELEASE AND RELEASE any liability, including, but not limited to, liability arising from the negligence or fault of the released entities or persons, for my death, disability, personal injury, property damage, theft of property or actions of any kind that may occur in the future, including my travel to and from this activity to Green Baker Lodge and/or its directors, officers, employees, volunteers, representatives and agents, and activity holders and sponsors;

• (2) INDEMNIFY, HOLD AND PROMISE NOT TO REACH the entities or persons mentioned in this paragraph from all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of the release or otherwise manner.

I acknowledge that Green Baker Lodge and its directors, officers, volunteers, representatives and agents are NOT responsible for any errors, omissions or acts of any party or entity performing a specific activity on its behalf.

I recognize that this activity may involve testing a person’s physical and mental limits and carries the possibility of death, serious injury, and loss of property. Risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicle traffic, lack of hydration, and the actions of other people, including, among others, participants and volunteers, monitors, and/or producers of the activity. These risks are not only inherent to the participants, but are also present for the volunteers.

I hereby give my consent to receive medical treatment that may be deemed appropriate in the event of injury, accident and/or illness during this activity.

I understand that while participating in this activity, I may be photographed. I agree to allow my image, video or film to be used for any legitimate purpose by activity owners, producers, sponsors, organizers and assignees.

The Accident Liability Waiver and Waiver Form will be construed broadly to provide a waiver to the maximum extent permitted by applicable law.