Construction Release Of Liability

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Construction Release of Liability
This Release and Waiver of Liability (the “Release”) is executed on this ____ day of ________, 2009 by
___________________________________ (the “Undersigned”) in favor of Liability Waiver, Inc. its
directors, officers, agents, employees, representatives, attorneys, successors, assigns, subsidiaries,
parent companies and affiliates (collectively known as “Liability Waiver, Inc”).
The Undersigned desires access to Liability Waiver, Inc’s manufacturing facility located at 29 Pitman
Road, Barre, VT 05641 (the “Facility”). The Undersigned understands that the Facility is a
manufacturing plant location and may have dangerous conditions, including the presence of
hazardous materials, that may pose significant risks, and that timely medical attention can not be
guaranteed by Liability Waiver, Inc, all of which may involve hazards to the Undersigned, including,
but not limited to, bodily injury, personal injury, illness, death, property damage or other loss.
The Undersigned hereby freely, voluntarily, and without duress executes this Release under the terms
below:
1. Release and Waiver
As consideration for gaining access to the Facility, the Undersigned does hereby release and forever
discharge, and agrees to defend, indemnify and hold harmless Liability Waiver, Inc from and against any
and all loss, damage, expense, liability, claim, injury, settlement, judgment, award, fine, penalty, charge or
demand of any nature (hereinafter collectively referred to as “Claim”), either in law or in equity, which
arises or may hereafter arise from Undersigned’s activity on or around the Facility, including any Claim
which arises or may hereafter arise from the Undersigned’s ingress and egress in and to the Facility,
whether by roadway or otherwise, except, however, not to the extent that the same be caused by or result
from the gross negligence of willful misconduct of Liability Waiver, Inc.
2. Medical Treatment
Undersigned does hereby release and forever discharge Liability Waiver, Inc from any Claim whatsoever
which arises or may hereafter arise on account of any first aid, treatment, or service rendered in
connection with the Undersigned’s activities on or around the Facility, including any Claim that arises
from the Undersigned’s ingress or egress in and to the Facility, whether by roadway or otherwise, whether
the same be caused by or result from any matter, thing or condition, negligence or fault of Liability
Waiver, Inc.
3. Assumption of Risk
The Undersigned hereby expressly and specifically assumes any and all risk of any and all activities
undertaken in, on or around the Facility, including any means by which the Undersigned accesses or exits
the Facility, and releases Liability Waiver, Inc from all Claims relating to or arising out of any bodily
injury, personal injury, illness, death, or property damage or other loss resulting from any such activity.
4. Insurance
The Undersigned understands that Liability Waiver, Inc does not carry or maintain health, medical, or
disability insurance coverage for the Undersigned. The Undersigned is expected and encouraged to obtain
his or her own medical or health insurance coverage. Further, Liability Waiver, Inc does not provide
workers compensation or malpractice insurance or any other employee benefits to the Undersigned of any
kind whatsoever.

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