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Rental Form & Disclaimer

Please print out this form, then either:

Fax to: 1 867 993 6271  

or

Scan & e-mail to:   yukonhostels@yahoo.ca

DAWSON CITY RIVER HOSTEL


 
Destination______________________________________________________________________________________

 
Name___________________________________________________________________________________________

 
Address_________________________________________________________________________________________

 
Telephone of Contact______________________________________________________________________________

 
Canoe  /  Bicycle / Other____________________________________________________________________________

 
Equipment_______________________________________________________________________________________

 
Credit Card___________________________________________________________   Date______________________

 
Departure Date____________________________________________________________________________________

 
Estimated Return__________________________________________________________________________________

 
Disclaimer to be read and signed by all customers:
 
We, the undersigned, hereby acknowledge the inherently hazardous nature of the activities in which we propose to participate.
I understand, and agree, that Dawson City River Hostel, and its agents, accept no responsibilities or liability whatsoever for any loss or injury or damage to person or property or any inconvenience whatsoever, including suffered directly or indirectly, through any cause whatsoever, including but not limited to transportation by road or river, camping, hiking, bicycling, boat trips and canoe trips, including negligence on the part of the company or its servants or agent whether such injury or inconvenience be caused to me or to a person for whom I am responsible.
 
I hereby agree to forego any legal action, including any action in court, against the company for any reason whatsoever.
 
In entering into this agreement I am not relying on any oral or written representations or statements made by the operator, its employees, servants, agents or representatives, including brochures to induce me on the operator's rental activity.
 
I confirm that I have read and understood this agreement prior to signing it and agree that this Agreement will be binding upon by heirs, next  of kin, administrators, successors and assigns.
 
I am at the date of this agreement of the full age of nineteen (19) years or older.
 
WARNING:  By  signing this agreement you may give up your legal rights.
 


SIGNED this_______________day of____________________20_____

 
Signature_______________________________       Please print your Name______________________________________

 
Witness_________________________________     Please print your Name______________________________________                                 
 

 
Signature_______________________________       Please print your Name_____________________________________
 

 
Signature_______________________________       Please print your Name_____________________________________

 
In the presence of:
 

 
Witness_________________________________     Please print your Name______________________________________