United States Sailing Assoc sailing instruction U.S.C.G. Captained charters Scuba tours to local reef Maintenance of mooring systems Pleasure charters to Deception Pass, Coupeville, Langley, LaConner, Freeland and other waterfront towns Transport of construction materials to waterfronts Capt. Lawrence F. Baum, Master, 100 tons camanosail@camano.net  www.camanosail.com 425-314-9824  370 N., East Camano Dr., Ste 5-260 Camano Island, WA  98282

                                                                                         ASSUMPTION OF RISK AND RELEASE FORM                                

Customer/Charteree/Auction Winner Name______________________________________________

Address  ____________________________________________________________________________

City___________________________State______________Zip_________________________

Phone, Home_______________________  Phone, Work/cell______________________________

E-mail______________________________________________(this will not be shared)

Emergency name (1) to call__________________________________

Emergency number (1)______________________________________

Emergency name (2) to call__________________________________

Emergency number (2) to call________________________________

Sex   M   F      Birthdate________________________

Putting out to sea in, or working around a boat is inherently risky.  Injuries to Clients, Charterees or Auction Winners  in keel sailboat programs or in powerboat or sailboat charters or rentals for sailing, fishing, crabbing, shrimping, sightseeing, leisure or other on-the-water boating activities may occur from risks inherent in these activities, as for example from working with tools, placing stress on the body that it has not been prepared for; from accidents in learning or practicing techniques; from failing to follow training, racing, or safety rules; from  failing to follow the instructions or warnings of the person in charge; from failure to use appropriate common sense and practices while boating or fishing;  from the use of transportation to and from events and from the administration of first aid, CPR or the use of an AED (automatic defibrillation device).  Other non-exclusive risks taken by going out on a boat include, for example, I might slip and fall; I might be struck by a part of the boat or objects on shore; the boat may capsize or sink; I might be thrown or fall overboard into cold water; my boat may hit another boat or run into an obstruction or the shore, and the collision injure or kill me; while fishing I might get pierced with a fishhook or be otherwise injured by the equipment used for fishing, crabbing or shrimping; I may be injured by the catch (e.g. crab, shrimp, fish) or by other plant or animal inhabitants of the waters of Puget Sound.    The severity of the injury can range, for example,  from minor cuts, scrapes, stings, piercings, muscle strains or broken bones to catastrophic injury such as paralysis or even death. I will be exposed to the weather, including rain, wind, cold and sun; I might become ill through chill or suffer sunburn and heat exhaustion or heatstroke.  In order to minimize and avoid injuries such as these I will obey the directions of the instructors or the vessel's master or my employer and will follow all safety rules and will not engage in behaviors that could either compromise my or other people's safety, welfare, comfort level or pleasure of the experience.  I will tell the instructor, vessel master and/or my employer about any limitations or medical restrictions that might compromise my health or the health, safety or welfare of others during participation in any activities of Camano Sail and Power; I will inform the person in charge of
the vessel of any actions on the part of the boat, crew, other passengers, other employees, independent contrctors working for Camano Sail nd Power or volunteers, that make me uncomfortable, sick or that otherwise compromise my comfort, health, pleasure and/or safety.

 In consideration for my acceptance as a participant, employee or volunteer in this boating activity, I agree to assume the risks, release and hold harmless Camano Sail and Power LLC, Lil' Cat Boat Co. Ltd, Washington State Parks, the Center for Wooden Boats, Kongsberg Underwater Technology Inc, University of Washington, their Board of Regents, and any of their employees, independent contractors, agents or volunteers and any sponsoring organizations, and any referring or peripherally involved organizations such as, for example, other businesses such as this Bed and Breakfast or store or business
(write in name of referring business here, if applicable)__________________________________________________,   from claims for
injuries, death or damages, which may occur from or as a result of my participation in these boating activities.  I agree that this assumption
of risk and release shall bind my heirs and my estate.

 Client, Charteree or Auction Winner participation authorized; risks assumed; and release granted.  Authorizing signature below acknowledges having read all statements above.  Client', Charteree's or Auction Winner's   signature required, or the signature of a parent or guardian is required if that participant, employee or volunteer is under 18 years of age.

 ______________________________            ____________________________           _______________

Printed name of Participant                          Signature of Participant                                 Date

and  if the Client, Charteree or Auction Winner is under 18 years of age:

 ______________________________                _________________________________               __________________

Printed name of parent or guardian            Signature of parent or guardian                   Date