Adventure Activity Registration Form

"*" indicates required fields

First Name*

Last Name*

Date of Birth*

Email*

Address*

Mobile*

My participation in the activity(s) selected is voluntary. I understand that the selected activities may involve accidental injury and hereby voluntarily assume such risks. Knowing these risks, I want to participate in this activity(s). I hereby assume the risk, and hereby waive, release, discharge Lough Allen Adventure, its officers, employees, activity instructors and assistants, and all officers and employees where said activity(s) will take place, for any and all claims for damages for personal injuries, or claims for damages to property, which me or my heirs, assigns, executors or administrators may have or which may accrue to my participation in this activity. I have read the above and understand that important legal rights are being waived

Do you have any allergies or medical conditions?*

Yes

Explain Condition

Please indicate your level of water confidence and swim ability level below*

Any additional information can be entered below

Signature*