RELEASE FROM LIABILITY, INDEMNITY
AND HOLD HARMLESS AGREEMENT
I, ________________________________________, in consideration of my being
allowed to ______________________________________________________________
_____________________________________________________do forever RELEASE,
acquit, discharge and covenant to hold harmless the Town of Walpole, a municipal
corporation of the Commonwealth of Massachusetts, and its successors, departments,
officers, employees, servants, attorneys and agents, of and from any and all actions,
causes of action, claims, demands, damages, costs, loss of services, expenses and
compensation on account of in any way arising out of, directly or indirectly, all known
and unknown personal injuries or property damage which I may now or hereafter have or
may acquire, resulting or to result from said participation in the aforementioned activities.
Furthermore, I hereby agree to protect the Town of Walpole and its successors,
departments, officers, employees, servants, attorneys and agents against any claim for
damages, compensation or otherwise arising out of or resulting from any injury to any
party in connection with said participation in the aforementioned activities and to
INDEMNIFY, reimburse or make good to the Town of Walpole or its successors,
departments, officers, employees, servants and agents any loss or damage or costs,
including attorneys’ fees, which the Town of Walpole or its representatives may have to
pay if any litigation arises from said participation in the aforementioned activities.
I hereby further covenant for myself, my successors and assigns not to sue the
said Town of Walpole, its departments, officers, employees, servants, attorneys, and
agents on account of any such claim, demand or liability.
Witness my hand and seal this ________ day of __________________________.
____________________________________
THIS FORM MAY NOT BE ALTERED