Assumption And Acknowledgment Of Risks And Release Of Liability Agreement printable pdf download

ASSUMPTION AND ACKNOWLEDGMENT OF RISKS

AND

RELEASE OF LIABILITY AGREEMENT

In consideration of being allowed to participate in any way for the _________________ its

related events and activities, the undersigned, acknowledges, appreciates, and agrees that:

The risk of injury from the activities involved in this program is significant, including the

potential for permanent paralysis and death, and while particular rules, equipment, and

personal discipline may reduce this risk, the risk of serious injury does exist; and,

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown,

EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and

assume full responsibility for my participation; and,

I willingly agree to comply with the stated and customary terms and conditions for

participation.

If, however, I observe any unusual significant hazard during my presence or

participation, I will bring such to the attention of the nearest official immediately; and

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin,

HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the __________________,

its officers, officials, agents and/or employees, other participants sponsoring agencies,

sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the

event (“Releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY,

DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE

NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by

law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK

AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I

HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT

FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

X______________________________________ Age: ____ Date Signed: ________________

PARTICIPANT’S SIGNATURE

________________________________________

PARTICIPANT’S NAME

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE

(UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent

and agree to his/her release as provided above of all the Releases, and, for myself, my heirs,

assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases from

any and all liabilities incident to my minor child’s involvement or participation in these programs

as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to

the fullest extent permitted by law.

X_____________________________________

______________________________

PARENT/GUARDIAN’S SIGNATURE

EMERGENCY PHONE #(s)

Date Signed: _________________________

_______________________________

NOTE: THIS IS A SAMPLE WAIVER FORM ONLY. FINAL WORDING SHOULD BE DIRECTED

BY THE INSURED’S COUNSEL.

Assumption And Acknowledgment Of Risks And Release Of Liability Agreement

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