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Sample Accident Waiver Partial Preview
ACCIDENT WAIVER AND RELEASE OF
LIABILITY FORM
Name of the
Activity or Event: __________________________Date
of Activity or Event: __________________
Check One: __
Field Trip __ Youth Activities __ Employment
Related __ Other
Description:
_____________________________________________________________________
I HEREBY ASSUME ALL OF THE RISKS OF
PARTICIPATING AND/OR VOLUNTEERING IN THIS ACTIVITY
OR EVENT, 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, have sufficiently prepared or
trained for participation in the activity or event,
and have not been advised to not participate by a
qualified medical professional. 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 event holders, sponsors, and
organizers of the activity or event in which I may
participate, and that it will govern my actions and
responsibilities at said activity or event.
In consideration of my application
and permitting me to participate in this event, I
hereby take action for myself, my executors,
administrators, heirs, next of kin, successors, and
assigns as follows: |
