Plant Walk with Blue Jay Botanicals: Registration Form

Plant Walk: Introduction to Wild Edibles (view event details here)

When: Sunday, May 5, 2024

Time: 1pm - 3pm

Where: Ferguson Forest, Kemptville, Ontario. (Meeting place will be provided via email after you register.)

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Email *
Full Name *
Phone Number *
Address *
Emergency Contact (Name and Phone Number) *
Do you wear a Medic-Alert Tag or any other marker of a medical problem?
*
Do you have allergic or anaphylactic reactions to any environmental substances, foods, drugs, insect bites or stings?
*
Do you have any other health-related disease, condition, or concern that program guides should be aware of?
*
If yes, please describe:
Waiver
In consideration of the services of Blue Jay Botanicals, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf, I hereby agree to release, indemnify, and discharge Blue Jay Botanicals, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:• I acknowledge that outdoor activities in natural areas entail known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: Slipping and falling; falling objects; water hazards; exhaustion; exposure to temperature and weather extremes which could cause hypothermia, hyperthermia (heat related illnesses), heat exhaustion, sunburn, dehydration; and exposure to potentially dangerous wild animals, insect bites, and hazardous plant life; accidents or illness can occur in remote places without medical facilities and emergency treatment or other services rendered; consumption of food or drink; equipment failure; improper lifting or carrying; my own physical condition, and the physical exertion associated with this activity.     Furthermore, Blue Jay Botanicals employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, incorrect information, and the equipment being used might malfunction.• I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.• I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Blue Jay Botanicals from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Blue Jay Botanicals equipment or facilities, including any such claims which allege negligent acts or omissions of Blue Jay Botanicals.• Should Blue Jay Botanicals or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.• I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.• I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Blue Jay Botanicals on the basis of any claim from which I have released them herein.  I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.
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Signature: Full Name *
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