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    2018 Sample Waiver and Release

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    nia tesda
    This waiver and release of liability form outlines the risks of participating in an organization's program and related events. It states that (1) there is a significant risk of injury, including paralysis or death, from participating, (2) the participant knowingly assumes these risks, and (3) the participant agrees to comply with the organization's terms and conditions. The form releases the organization and related parties from any liability or claims for injury arising from participation, even if due to negligence. For minor participants, the parent or guardian must also consent and agree to this waiver and release on behalf of the child.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    2018 Sample Waiver and Release

    Uploaded by

    nia tesda
    105 views1 page
    This waiver and release of liability form outlines the risks of participating in an organization's program and related events. It states that (1) there is a significant risk of injury, including paralysis or death, from participating, (2) the participant knowingly assumes these risks, and (3) the participant agrees to comply with the organization's terms and conditions. The form releases the organization and related parties from any liability or claims for injury arising from participation, even if due to negligence. For minor participants, the parent or guardian must also consent and agree to this waiver and release on behalf of the child.

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    Original Title

    2018-Sample-Waiver-and-Release

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    © © All Rights Reserved

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    This waiver and release of liability form outlines the risks of participating in an organization's program and related events. It states that (1) there is a significant risk of injury, including paralysis or death, from participating, (2) the participant knowingly assumes these risks, and (3) the participant agrees to comply with the organization's terms and conditions. The form releases the organization and related parties from any liability or claims for injury arising from participation, even if due to negligence. For minor participants, the parent or guardian must also consent and agree to this waiver and release on behalf of the child.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    105 views1 page

    2018 Sample Waiver and Release

    Uploaded by

    nia tesda
    This waiver and release of liability form outlines the risks of participating in an organization's program and related events. It states that (1) there is a significant risk of injury, including paralysis or death, from participating, (2) the participant knowingly assumes these risks, and (3) the participant agrees to comply with the organization's terms and conditions. The form releases the organization and related parties from any liability or claims for injury arising from participation, even if due to negligence. For minor participants, the parent or guardian must also consent and agree to this waiver and release on behalf of the child.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    NOTE: This is a SAMPLE Waiver/Release form. It is for guidance and informational purposes only.

    Final
    wording should be as directed by the insured's counsel, but observing the principles represented within the
    document. DO NOT RETURN IT WITH YOUR APPLICATION.

    WAIVER AND RELEASE OF LIABILITY -- READ BEFORE SIGNING

    In consideration of being allowed to participate in any way in the (name of organization) program, its related
    events and activities, I, (name of participant) , the undersigned, acknowledge, appreciate, and agree that:
    1. The risk of injury from the activities involved in this program is significant, including the potential for
    permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce
    this risk, the risk of serious injury does exist; and,
    2. 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,
    3. 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 remove myself
    from participation and bring such to the attention of the Company immediately; and,
    4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY
    RELEASE, INDEMNIFY, AND HOLD HARMLESS (name of organization) and USA Cycling, Inc., their
    officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers,
    and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITH RESPECT TO
    ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with
    my presence or participation, 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

    FOR PARENT/LEGAL GUARDIAN OF PARTICIPANTS OF MINORITY AGE

    This is to certify that I, as parent/legal guardian with legal responsibility for this participant, do consent and
    agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns,
    and next of kin, I release and agree to indemnify and hold harmless the Releasees 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 _______________________________________________ Date Signed: __________
    PARENT/LEGAL GUARDIAN SIGNATURE (print name)

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