GLADSTONE VENTURES, LLC
D/B/A STACEY’S SURF CAMP
WAIVER AND RELEASE OF LIABILITY
DISCLAIMER: GLADSTONE VENTURES, LLC D/B/A STACEY’S SURF CAMP (“STACEY’S SURF”),
JACOB S. PERSKIE AND JOHANNA M. PERSKIE (THE “PERSKIES”), THE CITY OF MARGATE CITY
(THE “CITY”), AND THE MARGATE CITY BEACH PATROL (“MCBP” AND TOGETHER WITH
STACEY’S, THE PERSKIES, AND THE CITY, THE “RELEASED PARTIES”) ARE NOT RESPONSIBLE FOR
ANY INJURY (OR LOSS OF PROPERTY) SUFFERED BY THE UNDERSIGNED PARTICIPANT WHILE
PLAYING, PRACTICING, OR IN ANY OTHER WAY INVOLVED IN THE SPORT OF SURFING FOR ANY
REASON WHATSOEVER, INCLUDING ORDINARY NEGLIGENCE ON THE PART OF THE RELEASED
PARTIES AND THEIR AGENTS, EMPLOYEES, VOLUNTEERS, OR REPRESENTATIVES.
THE RELEASED PARTIES ARE NOT RESPONSIBLE FOR ANY INJURY (OR LOSS OF PROPERTY)
SUFFERED BY THE UNDERSIGNED PARTICIPANT WHILE PARTICIPATING IN SURFING ACTIVITIES
ASSOCIATED WITH THE RELEASED PARTIES, INCLUDING ALL TRAVEL ASSOCIATED WITH
PARTICIPATION IN SUCH ACTIVITIES.
BY SIGNING THIS DOCUMENT, I ACKNOWLEDGE THAT I AM GIVING UP CERTAIN RIGHTS, INCLUDING
THE RIGHT TO SUE THE RELEASED PARTIES AND OTHERS. I FURTHER ACKNOWLEDGE THAT I MAY
NOT PARTICIPATE IN ANY STACEY’S SURF CAMP OR OTHER EVENT UNLESS THIS DOCUMENT IS
SIGNED.
RELEASE
In consideration of my participation in surfing activities, I hereby knowingly and voluntarily release and covenant not to sue
the Released Parties, their representatives, Boards of Trustees, any of its sponsors, lessors, volunteers, referees, employees,
instructors, coaches, judges or agents, successors, assigns, insurers, reinsurers, their agents or employees, counselors,
investors, sponsors, promoters, advertisers, surf instructors, photographers, videographers, and “good Samaritans”
(together, the “Releasees”), from any and all present and future claims resulting from ordinary negligence on the part of the
Releasees for property damage, personal injury, or wrongful death, arising as a result of my engaging in or receiving instructions
in surfing activities or any activities associated with my participation in surfing activities, wherever, whenever, or however
the same may occur. I hereby knowingly and voluntarily waive and forever discharge any and all claims against the
Releasees resulting from their or others’ ordinary negligence, both present and future, that may be made by me, my
family, estate, heirs, or assigns.
ACKNOWLEDGEMENT AND ASSUMPTION OF THE RISK
Further, I am aware that surfing is an aggressive, physical sport involving severe cardiovascular stress and violent physical
contact and body movements. I understand that surfing involves certain risks, including but not limited to, death, drowning, serious
neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury to virtually all bones, joints,
muscles, and internal organs, and that equipment provided for my protection may be inadequate to prevent serious injury. I
further understand that surfing involves a particular high risk of drowning, head, and neck injury. I understand that these
injuries or outcomes may arise from my own or others’ negligence or the condition of the ocean and/or beach, condition of
participants, equipment and actions of others. In addition, I understand that participation in surfing involves activities incidental
thereto, including, but not limited to travel to and from the site of the activity, participation at sites that may be remote from available
medical assistance, and the possible negligent or reckless conduct of other participants.
I knowingly and voluntarily assume these risks along with all others known or unknown associated with my
participation in surfing and assume full responsibility for any and all risks of loss and personal injury, including mental
trauma and death, that may be sustained by me, or any loss or damage to property owned by me, as a result of
participating in surfing.
I represent and warrant that at the time of my participation in any Stacey’s Surf surfing activities, I will be 100% alcohol and drug free
and will not have used any such substance within the last 8 hours, nor will I in the future before associating with Stacey’s Surf.
I agree to return all equipment in the same condition and to pay for any lost, stolen, or damaged equipment.
I further certify that I am in good health and able to participate in surfing activities. I will disclose any special physical limitations
and authorize Stacey’s Surf and its agents permission to request treatment as necessary to ensure my wellbeing. I further agree to
comply with all stated and customary terms and conditions of participation in surfing and represent that if I observe any unusual or
significant hazard during my presence at or participation in Stacey’s Surf surfing activities, I will remove myself from participation
and bring such to the attention of the nearest representative of Stacey’s Surf immediately.
I give my permission to have photographs or video taken of me during surfing activities and for Stacey’s Surf to publish my
name, image, likeness, recorded voice, film, photo or video in advertising, marketing, product, packaging, or other uses,
without compensation and without restriction as to duration, media or frequency. I acknowledge that all photographs and video
taken by Stace’s Surf are considered services rendered by Stacey’s Surf, are non-refundable, shall only be used for my personal,
non-commercial, non-profit enjoyment, and that Stacey’s Surf may use all photographs and video taken of me for marketing
purposes, including but not limited to publishing the same on social media or on staceyssurfcamp.com. I consent to such uses and
hereby waive all rights to compensation in connection with the same.
I understand that an instructor will be pushing or riding with me from behind and accept this process and absolve the Releasees from
any claims of inappropriate physical or sexual contact, abuse, or harassment.
I understand that Stacey’s Surf does not maintain insurance for me. I accept that the Released Parties do not provide any insurance
for me, neither medical, disability, completed operations, product liability, nor life insurance for any injury, loss, damage, death, or
claim with may result from my association with Stacey’s Surf. I hereby give up an release any and all benefits from any insurance
policy in which the Released Parties may be named as insureds. In the event of my injury, disability, damage, death, or loss, I agree
that the Released Parties will suffer no financial, economic or recoverable loss. I further agree that in the event I suffer any injury,
disability, damage, death, or loss, I will first look to recover from any insurance for which I am the beneficiary, which insurance
shall be primarily responsible for covering any and all of my losses.
I further acknowledge that the ocean contains wildlife, including but not limited to sharks, bluefish, stingrays and jellyfish, which
may pose a serious danger. I acknowledge that marine life may attack with no warning and that such attacks may result in serious
injury or death. I acknowledge that I may have allergies to jellyfish, fish eggs, or other marine life that I am unaware of. I
acknowledge that exposure to the sun may result in sunburn, blisters, or discomfort, and that sun-care products may not be enough
to protect me from the long-term effects of sun exposure. I acknowledge that there may be hazardous materials and pollution on the
beach and in the ocean. I expressly release the Releasees from any and all liability & claims relating to or arising from marine life
and/or sun exposure.
I understand that Stacey’s Surf makes no representation or warranties of any kind about the skills or qualifications of the
Releasees or other participants in surfing activities, or about the conditions of the ocean, beach, piers, groins, outfall pipes, or
other objects in or near the ocean, whether or not submerged, and whether known or unknown. I understand that medical
personnel will not be present during Stacey’s Surf surfing events. I understand that it is my sole responsibility to ensure that my
physical condition and athletic skills are suitable for the risks I will encounter. I recognize that Stacey’s Surf has agreed to
allow me to participate in Stacey’s Surf surfing activities on the condition that I sign this Waiver and Release of Liability and
agree to be bound by its terms. I have signed this Waiver and Release of Liability in consideration of the benefits I will receive
from voluntarily participating in Stacey’s Surf surfing activities.
I further agree to indemnify and hold harmless the Released Parties, any and all venues, coaches, judges, representatives and
any and all other associated entities from any and all claims arising as a result of my engaging in or receiving instruction in
surfing activities, wherever, whenever, or however the same may occur. I understand that this waiver is intended to be as
broad and inclusive as permitted by the laws of the State of New Jersey and agree that if any portion is held invalid, the
remainder of the waiver will continue in full legal force and effect. I further affirm that the venue for any legal proceedings
arising out of, relating to, or touching upon this Waiver and Release of Liability shall be in the State of New Jersey.
I affirm that I am of legal age or as a minor am having a legally recognized parent or guardian execute and I/we are freely
signing this agreement. I have read this form and fully understand that by signing this form, I am giving up legal rights
and/or remedies which may be available to me for the ordinary negligence of Stacey’s Surf, the Perskies, the City, MCBP, or any of
the Releasees.
THIS IS A GENERAL RELEASE AND WAIVER OF LIABILITY FROM THE UNDERSIGNED TO THE RELEASEES. I
HAVE READ THIS GENERAL RELEASE AND WAIVER OF LIABILITY CAREFULLY, UNDERSTAND ITS TERMS,
UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGNED IT VOLUNTARILY
AND UNDER MY OWN FREE WILL WITHOUT ANY INDUCEMENT. THIS GENERAL RELEASE COVERS ANY AND
ALL ACTIVITIES, CAMPS, LESSONS, OR OTHER EVENTS PUT ON BY STACEY’S SURF.
I AM SIGNING THIS AGREEMENT ELECTRONICALLY. I AGREE THAT
MY ELECTRONIC SIGNATURE IS THE LEGAL EQUIVALENT OF A WET-INK SIGNATURE. I FURTHER AGREE
THAT MY USE OF A KEYBOARD, MOUSE, OR OTHER DEVICE TO SELECT AN ITEM, BUTTON, ICON, OR SIMILAR
ACT/ACTION TO CONFIRM MY AGREEMENT TO THESE TERMS IS THE LEGAL EQUIVALENT OF A WET-INK
SIGNATURE. NO CERTIFICATION AUTHORITY OR OTHER THIRD-PARTY VERIFICATION IS NECESSARY TO
VALIDATE MY E-SIGNATURE AND THE LACK OF ANY SUCH CERTIFICATION OR THIRD-PARTY VERIFICATION
WILL NOT IN ANY WAY AFFECT THE ENFORCEABILITY OF THIS GENERAL RELEASE AND WAIVER OF
LIABILITY.