Individual
Small Group 3-10
Large Group 10+
Partnership – If Nature and Forest Therapy would work well with your business offerings, let’s collaborate.

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For your convenience you may fill out the forms below before your participation with Nature Walks RX. You may also download, fill out, save and email the PDF of the form to NatureWalksRX@gmail.com.

If you would prefer, you can download, fill out, save and email your Health Questionnaire to NatureWalksRX@gmail.com. Click here to download.

HEALTH QUESTIONNAIRE

Does your Doctor know you are going to participate in this program?
Does your Emergency Contact know you will participate?
Do you wear a Medic-Alert Tag or any other marker of a medical problem?
Do you have allergenic or anaphylactic reactions to any insults, such as environmental substances, foods, drugs, insect bites or stings?
If you walked on the level for a mile at an average pace would you get out of breath, have pains in the chest, develop muscle fatigue or have pains in your legs?
Do you have any other health-related disease, condition, or concern that program guides should be aware of?

This information is accurate and complete. I agree to communicate fully with program instructors and Guides any health concerns that may arise. I give my permission to staff of the Association of Nature and Forest Therapy Guides to seek emergency medical diagnosis or treatment for me in the event that I am unconscious or unable to make my own decisions. I understand that should I need medical care for any reason while participating in this program the role of Guides will be limited to emergency first-aid and either transportation to the nearest medical facility, or contacting such a facility to arrange emergency transport.

If you would prefer, you can download, fill out, save and email your Participant Agreement and Release Form to NatureWalksRX@gmail.com. Click here to download.

GUIDED NATURE WALK PARTICIPANT AGREEMENT

Part 1: Liability Release: You are responsible for your own well-being and safety on this walk

1. I acknowledge outdoor activities in natural areas entail known and unanticipated risks that could result in injury.

2. I agree and promise to accept responsibility for my own safety and well-being during this activity. I understand that I may at any time opt to not participate in any part of the activity should I feel that it is not safe, or simply that I do not want to participant for any reason.

3. I voluntarily release and hold harmless Nature Walks Rx, Darcy O’Brian, and the Association of Nature and Forest Therapy Guides and Programs (ANFT) and the individuals who are acting as guides on this walk from any and all claims of liability which are in any way connected with my participation in this activity.

4. If I have a medical condition or health concern that I think the guides should be aware of, I will verbally inform them at the beginning of the walk.

Part 2: Model Release: With your permission, Nature Walks Rx and Darcy O’Brian may take photographs of you and your group on this walk. We would like your permission to use these photographs in promotional materials which may include social media, website, printed flyers and books, and videos. We are sometimes asked by news reporting agencies and publications to provide photos for articles they are writing about nature connection topics. We do this at no charge. We promise to carefully select photographs that show you in a way that we are confident you will like. If you are not comfortable with having photos that include you taken and possibly used in these ways, we prefer that you mark “No” in the box below; we want you to have a relaxed and stress-free experience on your walk.

Photographs
If you would prefer, you can download, fill out, save and email your Group Liability Release to NatureWalksRX@gmail.com. Click here to download.

PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK

In consideration of the services of Nature Walks Rx, and Darcy O’Brian their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf, I hereby agree to release, indemnify, and discharge Nature Walks Rx, and Darcy O’Brian on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:

1. I acknowledge that outdoor activities in natural areas entail known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: Slipping and falling; falling objects; water hazards; exhaustion; exposure to temperature and weather extremes which could cause hypothermia, hyperthermia (heat related illnesses), heat exhaustion, sunburn, dehydration; and exposure to potentially dangerous wild animals, insect bites, and hazardous plant life; accidents or illness can occur in remote places without medical facilities and emergency treatment or other services rendered; consumption of food or drink; equipment failure; improper lifting or carrying; my own physical condition, and the physical exertion associated with this activity. Furthermore, Nature Walks Rx employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, incorrect information, and the equipment being used might malfunction.

2. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless SY/CRP from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Nature Walks Rx equipment or facilities, including any such claims which allege negligent acts or omissions of Nature Walks Rx.

4. Should Nature Walks Rx or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.

6. In the event that I file a lawsuit against Nature Walks Rx I agree to do so solely in Humboldt County and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Nature Walks Rx on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

Darcy O'Brian - ANFT