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Shockwave Adventures Zambezi White-Water Rafting

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Thank you for completing our waiver form. Your submission for Zambezi White-Water Rafting event was processed successfully.

Hi - welcome!

Please let us know if you are a new customer, or a returning customer....

Name *
Surname *
email *

Are you a new customer?

I'm a new customer

Are you completing this on behalf of a minor?

For legal Guardian (All fields compulsory)

Guardian Full Name and Surname *
Relationship to minor *
Guardians valid Email Address *
Guardians contact number (also for emergencies) *
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Minor's name *
Minor's Surname *
Minor's date of birth *
Minor's gender *
Minor's age *
Any medical conditions *
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Participants First name
Participants First name *
Participants Last name
Participants Last name *
Participants Valid Email Address
Participants Valid Email Address *
Participants ID or Passport number or Date of Birth
Participants ID or Passport number or Date of Birth *
Contact_number
Contact_number *
Participants ID or Passport number (Minors - date of birth)
Participants ID or Passport number (Minors - date of birth) *
Emergency Contact person
Emergency Contact person
Emergency Mobile Number
Emergency Mobile Number
Emergency Contact Number
Emergency Contact Number
Country
Country *
Gender
Gender *
Age Group
Age Group
CAN YOU SWIM?
CAN YOU SWIM? *
ANY MEDICAL HISTORY
ANY MEDICAL HISTORY *
DO YOU REGULARLY CARRY ANY MEDICATION?
DO YOU REGULARLY CARRY ANY MEDICATION? *
IF YOU ANSWERED YES PLEASE STATE
IF YOU ANSWERED YES PLEASE STATE
DATE OF ACTIVITY
DATE OF ACTIVITY *
How did you hear about us?
How did you hear about us? *
Do you possses a Valid Covid Travel Certificate?
Do you possses a Valid Covid Travel Certificate? *

By completing and submitting this form you are agreeing to the following:

The Zambezi River in the gorges below is classified as a Grade Five river. The official definition of a grade 5 river, as defined by the book of the British Canoe Union is as follows:

“Extremely difficult, long and violent rapids, steep gradients, big drops, pressure areas”

I acknowledge that I am aware that the consequences of an accident whilst rafting on the Zambezi River can be serious. I understand that in the course of a river descent, I can be thrown from the boat and fall into the water at any point on the river. I declare that I am not under the influence of alcohol or drugs and that I will not use any for the duration of the activity.

I acknowledge that I will be required to walk down and up a gorge in order to access and exit from the Zambezi River. I have been made aware that this is steep, rocky and may be slippery. I have also been made aware that after the raft trip, I will be transported to Victoria Falls by vehicle.

I will follow and comply with each and every instruction given by the Company, its guide or instructors, its employees or any of its agents. I acknowledge that this agreement sets out the full basis of the relationship between the Company and me.

The company will explained/illustrated and/or demonstrated to my satisfaction, the nature of risk and dangers of rafting and I accept these risks and accept that all the terms and conditions of this indemnity are clear and understood by me. I hereby indemnity the Company, its directors, its employees, its agents and contractors in respect of any claim for injury to myself whether fatal or otherwise, or loss/damage of my property which may occur during the rafting trip on the Zambezi River and/or my return by vehicle to Victoria Falls town.

I grant the Company the right to use any photographs and or videos in which I may appear for advertising and marketing purposes of which I will not claim remuneration from the said company.

I DECLARE THAT I HAVE READ AND FULLY UNDERSTOOD THE CONDITIONS OF THIS INDEMNITY

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