.  Parent/Guardian Permission Form

.  (This form is to be used for minors only-must be signed prior to going on river,use  of pool, canoe, tubing or any other equipment or facilities) 

    I hereby grant permission for my child(ren)__________________________________

________________________________________________________________________

To participate in tubing, fishing, canoeing, swimming or camping at Joey's River Paradise on date:__________, and I hereby agree as follows:

I fully understand and acknowledge that:

a) risks and dangers exist in my child's use of tubing, fishing, swimming, or camping equipment and my child's participation in these activities;

my child's participation could result in injury, illness and/or death or damage to personal property;

c) these risks and dangers may be caused by other participants, or by accidents, or by forces of nature or other causes.  Risks and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, selection of trail or river route, water level, weather conditions, risks of falling out of a raft, activities that take place in a wilderness, outdoor or recreational environment; and

d) I hereby accept and assume these risks and dangers.

I have been advised that my child must wear an approved personal flotation device at all times while on or in the water.  I affirm that my child will not be under the influence of alcohol or any controlled substances, and will not carry, use, or consume these substances before, during his/her stay or visit at Joey's River Paradise.  Any claims or dispute arising from my child's participation in Joey's River Paradise activities or use of equipment shall be venue in the Page County Courts of the State of Va.

My child is in good health for each activity in which he/she will participate.  I understand that strenuous physical excursion my be required and my child has NO Known physical disabilities of health problems, which will present any risks to his/her participation in the activities.

The above agreement shall be binding by the owners of Joey's River Paradise.

I have read the above and by signing and agree.  It is my intention to grant permission for my child to participate in Joey's River Paradise canoeing, fishing, swimming, tubing, camping activities, or any other such activities available.  And to assume and accept all risks associated therewith.

I understand I am reliable for my child's safety and well being while on these premises,  And any and all responsibility I as their parent/guardian assume.

Parents name(print)________________________________________________

Signature_________________________________________________________

Street, City, State and Zip___________________________________________

_________________________________________________________________

1) Child's name____________________________________________________

    Age________Date__________

    Child's signature________________________________

2) Child's name____________________________________________________

    Age_________Date________

    Child's signature______________________________

3)  Child's name________________________________

     Age_______Date________

     Child's signature________________________________

4)  Child's name___________________________________

      Age_____Date_______

      Child's signature_________________________

______________________________________________________________________

Joey's River Paradise      5532 Page Valley Road  Luray  Va  22835  (540)244-9231