Fill and Sign the Agreement and Release for Working at a Novelty Store Self Employed Form

Agreement and Release for Working at a Novelty Store Agreement made on the ___ day of __________, 20___, between _______________ of ___________________________________ (street address, city, county, state, zip code), referred to herein as ____________ , and ____________________ , d/b/a/ ________________________ located at _______________________ (street address, city, county, state, zip code), referred to herein as ______________________ , and said address of ______________ being sometimes referred to herein as the premises. Whereas, _________ enjoys working at ______________ from time to time; and Whereas, _________________ receives discounts on his purchases from _________________ from time to time; and Whereas _________________ will not allow _________________ to work at _________________ unless he executes this Agreement and Release; Now, therefore, in consideration of the matters described above, and of the mutual benefits and obligations set forth in this agreement, the parties agree as follows: I. Nature of Work (Describe what _________________ does). II. Payment for Work _________________ will allow _________________ a discount of ____% on goods purchased by _________________ at _________________. III. Duration of Agreement This agreement will last for one year from the date hereof, but may be terminated by either party for any reason or no reason. Paragraphs IV, V, and VI will survive the termination of this agreement. IV. Status of _________________ While _________________ considers himself an unpaid volunteer for ______________, in order to remove any doubt as to his legal status at ________________, _________________ understands and agrees that he is an independent contractor and will not be considered an employee of _________________ for any purpose or reason. V. Release, Waiver and Assumption of Risk A. _________________ , for himself his spouse, legal representatives, heirs and assigns, hereby releases, waives and discharges _________________, its employees, officers, agents, owners and/or assigns and each of them, hereinafter jointly and severally referred to as Releasee , from all liability to _________________ , his spouse, legal representatives, heirs and assigns, hereinafter jointly and severally referred to as Releasor , for any and all loss or damage, and any claim or damages resulting therefrom, on account of injury to Releasor = s person or property, even injury resulting in death of the Releasor, whether caused by the negligence of Releasee or otherwise, while the Releasor is on or around the premises of Releasee or resulting from Releasor’s being on around the premises of Releasee for any reason. B. Releasor agrees to indemnify the Releasee and hold Releasee harmless from any loss, liability, damage or cost Releasee may incur due to Releasor’s work on or about Releasee’s premises whether caused by the negligence of Releasee or otherwise. Releasor hereby assumes full responsibility for the risk of bodily injury, death or property damage due to working on the premises of Releasee or being on said premises for any reason. Releasor expressly agrees that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of _________________, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. VI. Mandatory Arbitration Any dispute under this agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. WITNESS our signatures as of the day and date first above stated. _________________ NOVELTY STORE ________________________ By__________________________ Name