Canot Volant

    Complete this form after confirming your reservation online or by telephone.

    RISK ACKNOWLEDGEMENT AND ACCEPTANCE FORM

    Date of your activity:

    Time of your activity:

    H

    Reservation on behalf of:

    This form must be completed by all people aged 16 and over and returned to us completed at least the day before your activity.
    If you are responsible for young people under the age of 16, you must complete the section for this purpose.
    Please note that children must appear on only one adult’s form.

    Participant identification

    Experience

    Responsibility


    You are responsible in the event of theft, loss or damage that occurs following use of the equipment.


    Replacement and repair costs (price + tax)

    • Flat edges

      100$

    • Crumpled canoe, perforated canoe

      $100 to full value

    • Deep scratches and splits

      10$ per inch

    • Bar

      30$

    • Rowing

      40$

    • Paddle

      75$

    • Flotation vest

      50$

    • Canoe

      1200$ - Full value

    • kayak

      500$ to 700$ - Full value

    Risks inherent to canoeing and kayaking


    I acknowledge that we have been informed about risks inherent to canoeing and kayaking.


    The risks associated with the activity
    we are about to engage in are, in a general but none restrictive way:

    • Injuries due to falls or other movements (sprain, fracture, etc.)

    • Injuries with blunt or cutting objects (branches, equipment, etc.)

    • Cold or hypothermia

    • Injuries resulting from accidental or non-accidental contact between individuals

    • Food allergies

    • Contact with water or drowning

    • Burns or heat disorders

    Health

    Gender

    Age

    Severe allergies

    YESNO

    Medication

    YESNON

    Do you have physical, emotional or behavioral health problems that would directly or indirectly limit you from canoeing and kayaking? Ex : Respiratory problems, heart problems, diabetes, vision problems, deafness, fear of water, limitation of your movements, etc.

    OUINON

    Pregnant woman

    OUINON

    If yes, for how many months ?

    If at least one yes:
    After having discussed with a person responsible for Au Canot Volant, I accept the additional risk which could lead to a possible worsening of my state of health.

    Emergency contact

    Confirmation of information and risks acceptance

    I declare that the information written in this form is accurate, to the best of my knowledge. I did not intentionally omit any information,
    relevant or not, regarding my health.

    I am aware that the information provided in this form is confidential and that it helps planning and
    supervising the security surrounding the activities I am about to take part of . With this information, Au Canot Volant can establish its
    clientele’s profile.

    I am aware that the activities offered by Au Canot Volant take place in natural or semi-natural terrains that could be
    uneven and that are far from medical facilities. This could result in longer waiting times in case of an emergency that requires an
    evacuation, which could worsen my health or my injury.

    Now that I know the risks and that I had a chance to talk about them with someone in charge, I declare that I have been informed about the risks inherent to these activities. I can begin the activity or the trip KNOWINGLY, WHILE FULLY ACCEPTING THE RISKS that could be associated with it.

    I also commit to actively dealing with those risks by adopting a preventive attitude towards myself and other people. Au Canot Volant has the right to exclude anyone who would pose a danger to herself (himself) or to the rest of the group.

    I understand I can leave this activity for any reason.

    Drugs and alcohol

    I undertake not to consume, have in my possession or be under the influence of any drugs, illicit substances or medications (prescription or not) that are not mentioned in section #2 of this form. I also confirm that I am not under the influence of alcohol or recreational drugs and that I will remain so for the duration of the activity.

    I am aware that any breach of these rules on my part could result in me being evicted without notice, and without possibility of reimbursement.

    Material liability discharge and authorization to intervene in case of emergency

    I, undersigned, hereby abandon any complaint or suit for damages related to any wear of my goods and equipment (normal wear,
    loss, breaking, theft, vandalism).

    I also authorize Au Canot Volant to decide, in case of an accident, to send me (by ambulance, helicopter, coast guard or by any
    other way) to a hospital or to a community health centre, and all this will be to my own expense.

    Young people under 16 years old

    If you have young people under 16 years old accompanying you for the activity,
    please complete this section.

    Each child must appear on only one form.

    Name of child(ren):



    Age(s)



    Does your child have a severe allergy, must take medication or have a physical, emotional or behavioral health problem that would directly or indirectly limit them from canoeing and kayaking ?
    YESNO

    I confirm that I am the parent or guardian of a minor participant(s) and that I am signing this risk acceptance and waiver form on my behalf as guardian/guardian of such child(ren). s).

    I declare that I have informed the minor(s) of all the above-mentioned risks or any other risk of which I am aware.

    I consent to the minor(s) participating in the activities organized by Au Canot Volant and approve all the terms and conditions of this form on behalf of the minor(s).

    Image rights

    I authorize Au Canot Volant to use the photos taken during the activity in order to promote the company, the activity and the tourist region without any remuneration.

    YESNO

    Newsletter

    Stay informed, subscribe to our Newsletter! (Maximum 4 shipments per year)

    YESNO