Produced by: Robin Haw (Secretary), Cedric Morel (Chairperson), Paul Reay (Treasurer), Kouichi Iwasaki (Founder)
We would like you to become aware of the safety issues while
walking / mountaineering with the TWMC, as all outdoor activities
have some element of risk. Following the Great East Japan Earthquake of March
11, 2011, it is especially important to be aware of the currently heightened
danger of aftershocks and landslides, as well as the risk of radioactive
contamination as a result of the damage incurred by the Fukushima Daiichi
nuclear reactor. Of course we shall not be going to
We are always very happy to assist you in preparing for the risks involved during walking. If you do not agree to sign the document, then please refrain from joining our activities until contacting and consulting a current committee member. In all cases, the TWMC is here to attempt to help you have a great time in the outdoors, but we cannot be responsible for your safety - this responsibility can only be yours and yours alone. Please be sensible and use your common sense to maximize your safety during any trip.
Similarly, all equipment either owned by the TWMC or other persons must be used at the individual persons own risk on club and/or private walks. Any equipment damaged or lost must be replaced in full or paid for in full to the owner(s).
I, (PRINT NAME) ______, hereby state that I wish to participate in the activities offered by Tsukuba Walking and Mountaineering Club (hereby stated as TWMC within this agreement), a non-profit organization. I recognize any outdoor activity may involve certain dangers, including but not limited to the hazards of traveling in mountainous terrain, accidents or illness in remote places, forces of nature, and the actions of participants and other persons. Following the Great East Japan Earthquake of March 11, 2011, I am aware that there is currently a heightened danger of aftershocks and landslides, and that there is a risk of radioactive contamination as a result of the damage incurred by the Fukushima Daiichi nuclear reactor. I further understand and agree that without some program providing protection of its assets and its leaders, TWMC would not be able to offer its activities.
In consideration of and as part payment (which I agree to pay) for the right to participate in the activities offered by TWMC, I agree to release, hold harmless and indemnify TWMC and its members from any and all liability, claims and causes of action arising out of or in any way connected with my participation or the participation of any minor that I am signing on behalf of in any activities offered by TWMC. I personally assume all risks in connection with these activities, and confirm that I have taken out personal insurance inclusive of helicopter rescue. If I am signing on behalf of a minor, I further agree to hold harmless and indemnify TWMC and its members from all liability, claims and causes of action which the minor may have arising from the minor`s participation in activities. The terms of this agreement shall serve as a release and indemnity agreement for my heirs, personal representative, and for all members of my family, including any minors. (Parent or legal guardian must sign for all persons under eighteen  years of age.)
I have read this release and indemnity agreement and have fully informed myself of its contents before I have signed it.
Signature of Participant: ____, Date:___
Signature of Parent or Guardian if Participant is under 18 years of age: _______, Date:____
Participant Contact Address, Tel, Fax, Email/Other
Emergency Contact Address, Tel, Fax, Email/Other