Fill and Sign the Employee Damages Form

Release by Employee of Damages Incurred as a Result of Drinking Alcohol Supplied by Employer Agreement made on the _________________ (date) , between __________________ _________________ (Name of Employee) of _________________________________ _____________________ (street address, city, state, zip code) , referred to herein as Employee, and _____________________________ (Name of Employer) , a corporation organized and existing under the laws of the state of ______________________ (name of state), with its principal office located at ____________________________________ ______________________ (street address, city, state, zip code) , referred to herein as Employer. Whereas , Employer has, will or is supplying Employee with ______________________ (describe alcohol, e.g., whisky, beer, etc., and amount), hereinafter called Alcohol ; and Whereas , the Alcohol is being supplied to Employee by Employer for ______________ _____________________________________________________ (state reason) ; and Whereas , Employer will not supply or give Alcohol to any Employee who refuses to sign this Release; Now, therefore, for and in consideration of the mutual covenants contained in this Agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Employee understands and agrees that drinking alcoholic beverages can be dangerous and cause such reactions and dangers as:  Seeing double, slurring one’s speech, and losing one’s sense of distance;  Loosening ones inhibitions;  Making bad judgments that can result in car crashes, violence, and sexual relations outside marriage.  Illness or death from alcohol poisoning; and  Being arrested, fined and/or imprisoned as a result of driving under the influence of alcohol. 2. The undersigned Employee f ully comprehends and assumes all risks involved in drinking alcoholic beverages and does now remise, release, quitclaim, and forever discharge Employer, its agents, successors and assigns, of and from any and all manner of actions, suits, debts, accounts, damages, judgments, executions, claims, or demands whatsoever in law or equity, or otherwise, which the undersigned Employee shall or may have, for, upon or by reason of any injury or damages that Employee may sustain or incur as a result of the drinking of said Alcohol. 3. Employee agrees to indemnify and hold harmless said Employer, its agents, successors and assigns from and against any and all claims, damages, losses, and expenses, including reasonable attorneys' fees, arising out of the use by Employee or his/her assigns of said Alcohol. WITNESS my signature as of the day and date first above stated. ________________________ (Signature of Employee) ________________________ (P rinted Name of Employee)