Date of Activity
DD slash MM slash YYYY
Time of Activity
Name of which the booking is booked under?
Date of Birth (required for anyone under 16 years)
DD slash MM slash YYYY
Emergency Contact - Contact name and relationship
Terms and Conditions
I declare that: - I am in good health and physically fit and have good eye sight. - That I am not suffering from any disability or medical condition, including pregnancy, which may make it unsafe for me to drive/ride. - The person filling out the form is 16years or over. - That I am not under the influence of alcohol, drugs or any other substance, legal or otherwise. - I accept that I will be responsible for any decision as to my fitness to participate in this activity. - I agree that Keypitts Off Road AdventuresLtd. reserve the right to terminate my participation of the drive/ride at anytime if they consider my actions to be dangerous, negligent and detrimental to my health and safety or other participants. I agree that Keypitts Off Road Adventures Ltd. cannot be held responsible for any accidents caused by my acting in a negligent manner, and that in the event of an accident so caused or contributed to my acting negligently, I waive my right to take legal action against Keypitts Off Road Adventures Ltd. and maybe liable to legal action by Keypitts Off Road Adventures Ltd. The 4x4 must be driven in a proper manner in accordance with the instructions given by theInstructor. Infringements of any of the following may result in the termination of your drive/ride: 1. Deviating from the course set by the Instructor 2. Ignoring instructions given by the Instructor. 3. Any other action considered to be careless or dangerous by the Instructor ADDITIONALLY 1. If driving the 4x4 – I hold a FULL UK DRIVING LICENCE and have shown the appropriate people. 2. There shall be no driving of the 4x4 before the induction brief is done 2. In the event of a wilful accident, the offending driver must pay for any damages caused to their vehicle and any other(s) 3. CRASH HELMETS MUST BE WORN and properly fastened during the drive/ride. 4. Seat belts MUST BE WORN AT ALL TIMES WHEN IN THE VEHICLE. 5. Management reserves the right to cancel the Tour without refund where necessary. 6. Failing to abide by the rules and regulations could cause DEATH or INJURY to yourself or others. RELEASE: I hereby release Keypitts Off Road Adventures Ltd. the owners of the property on which the activity is taken place and any other person participating in this activity with me who might injure me, howsoever arising, from any claims or liabilities without limitation. I make this release on behalf of heirs, my executors, administrators and myself. I understand that failure to abide by the rules and regulations could cause death or injury. I hereby declare that I have read and agree to abide by the above-mentioned conditions, rules and regulations. (Parent or Guardian to sign for anyone under 16 years of age) RIDERS UNDER THE AGE OF 16yrs: Parent/Guardian accepts full responsibility for the child named above and confirms I have read the above to him/her and accepts the child rides at his/her own risk.
Signature: Please type you name in full to declare that you have read and agree to abide by the above-mentioned conditions, rules and regulations.
If signing on behalf of rider please state relationship to the rider:
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