Acknowledgement of Risk Form

This form must be read and signed before you, the participant, may take part in the event described below. The purpose of the document is to inform you of the risks inherent in participating in the event. By completing and signing this document, you acknowledge that you understand and agree to the terms below.

Participant's Name:


IN CONSIDERATION of being permitted to participate in the excursion to (the "Event")


being held by Dalhousie’s Department of Earth Sciences (the “University”) on (Date)


I understand and agree that:

  1. The Event may include, but is not limited to, transportation by chartered bus, rental vehicle or other means of transportation to participate in strenuous and demanding physical activities such as, without limitation, walking, hiking, and light climbing with or without supervision by University trip coordinators;
  2. Although University trip coordinators will make efforts to provide supervision, I recognize that there is an element of risk in any activity associated with the outdoors. The University trip coordinators are not professional leaders, guides, or licensed first aid attendants. I am aware that the trip coordinators may not have completed an outdoor leadership course or have any further first aid training or experience and are in no manner whatsoever responsible for my safety;
  3. I understand and accept that there is a risk of injury, possibly of a serious nature, from participating in the Event. Injuries may result from, without limitation, traffic accidents, weather conditions, rough terrain, water-related accidents, the consumption of food or beverage, contact with other persons, equipment malfunction, insects, wildlife, sunburns, slipping, tripping, falling, or falling objects such as rocks, trees and branches and other hazards inherent to the environment and the Event;
  4. I will immediately notify the nearest representative of the University if at any time I observe any unusual hazard or unsafe condition, or I feel that I have experienced any deterioration in my physical, emotional or mental fitness impacting on safe participation in the Event;
  5. I understand that all applicable University rules and policies for participation must be followed, regardless of my role, and that at all times during the Event the sole responsibility for my personal safety rests with me;
  6. I declare that I have read, understood and agree to the contents of this Acknowledgment of Risk in its entirety and I sign it freely and voluntarily without any inducement.
 I confirm that I have read and understand and agree with the above.