Accident Waiver And Release Of Liability Form printable pdf download

Accident Waiver and Release of Liability Form

Name of Activity: Test Ride of a GoPet Electric Scooter

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY, including by way of example and

not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being

released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of

their possible liability without fault.

I certify that I am physically fit and I certify that there are no health-related reasons or problems which preclude my

participation in this activity or event.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the persons or entities being

released, sponsors, and organizers of any activity or event in which I may participate in the activity listed above, and that

it will govern my actions and responsibilities of said activity or event.

I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the

negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, or

actions of any kind which may hereafter occur to me including my traveling to and from this event, THE FOLLOWING

ENTITIES OR PERSONS: Personal Electric Transportation of Sarasota, Inc. (PETS, Inc.) and/or their directors,

volunteers, representatives, the activity or event holders, activity or event sponsors, activity or event volunteers, and

owners of properties where event / activity takes place.

I INDEMNIFY, HOLD HARMLESS, AND AGREE NOT TO SUE the entities or persons mentioned in the above paragraph

from any and all liabilities or claims made as a result or participation in this activity or event, whether caused by the

negligence of release or otherwise.

I acknowledge that this activity or event may involve a test of a person’s physical and mental limits and may carry with it

the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by

terrain, facilities, temperature, weather, acts of God, natural disaster, condition of participants, equipment, vehicular traffic,

vehicles, lack of hydration, actions of other people including, but not limited to, participants, volunteers, activity or event

holders, activity or event sponsors, representatives and/or producers of the event, property owners where event / activity

takes place, and or members of the general public. These risks are not only inherent to participants, but are also present

for volunteers.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or

illness during this activity or event.

I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or

film likeness to be used for any legitimate purpose by PETS, Inc. event holders, sponsors, organizers and

assignees.

IF MINOR CHILD (Under 18 years of age) IS PARTICIPATING IN THIS EVENT, the undersigned parent and legal

guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s

participation in the activity or event, and has agreed individually and on behalf of the child or ward, to the terms of the

accident waiver and release of liability set forth above. Parent / Legal guardian is fully responsible and indemnifies and

holds harmless all, but not limited to, referenced organizations or individuals listed and participating herein.

I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THIS DOCUMENT AND ITS CONTENT. I AM AWARE

THAT THIS IS A RELEASE OF LIABILITY AS WELL AS A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

Print Participants Name: ______________________________________ Age:____________

Signature of Participant: _______________________________________ Date:___________

Print Parent/Guardian Name

: _____________________________

(if participant is under the age of 18)

Signature of Parent/Guardian: ___________________________________________________

Address:______________________________________________________________________________

Telephone:_____________________________ Email:__________________________________

Accident Waiver And Release Of Liability Form

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