Health Declaration & Waiver

Official Kawasan Quest Canyoneering Waiver & Health Declaration. Sign online for a faster check-in at Kawasan Falls.

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Name *

First

Last

Email *

Date of Birth *

Gender *

• Male
• Female
• Prefer not to say

Emergency Contact Name & Phone *

Instructions:

• Please check the box only if the answer is YES.

Surgical Operation

• Have you had a surgical operation in the past 6 months?

of Emergency Name

Seizure Disorder

• Do you have a history of seizure disorders or epilepsy?

Pregnancy

• Are you currently pregnant?

Severe Allergies

• Do you have severe allergies to bee stings, food, or medications?

If you checked YES: Please specify condition, date of surgery, or type of allergy.

Year last TETANUS IMMUNIZATION: If you can’t remember, was it within the past five years?YesNo

Acknowledgment of Risk

• I understand that Badian Kawasan Canyoneering is a 3–5 hour eco-adventure activity in a remote setting where evacuation to modern hospital facilities is not immediately possible. I expect extreme weather, uneven/slippery terrain, and strong water currents.

Release of Liability

• I voluntarily assume all risks, including injury or death, and hereby release and forever discharge the Operator and Tour Guides from all liability for personal injury, death, or loss of property. I agree to follow all guide instructions and wear provided safety gear at all times.

Digital Confirmation

• I affirm that I am 18 years or older (or have a guardian's consent) and that the health information provided is accurate.

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