General Accident Waiver

GENERAL ACCIDENT WAIVER

This General Accident Waiver (the Agreement) is entered into by and between Participant Name: and Provider/Organization Name: . Provider Address:

RECITALS

WHEREAS, Participant desires to participate in activities, programs, events, or services administered, supervised or provided by Provider (the Activity); and

WHEREAS, Participant acknowledges that the Activity may involve physical exertion, exposure to the elements, hazardous conditions, equipment, and other risks that may result in personal injury, property damage, or death; and

WHEREAS, Provider requires execution of this Agreement as a condition to participation in the Activity in order to allocate responsibility and to permit Provider to conduct the Activity for all participants;

NOW, THEREFORE, in consideration of being permitted to participate in the Activity and other good and valuable consideration, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement: (a) "Activity" means the specific program, event or service described as: ; (b) "Releasees" means Provider and its officers, directors, employees, agents, volunteers, contractors and representatives.

2. ASSUMPTION OF RISK

Participant acknowledges and agrees that participation in the Activity involves inherent risks that may result in personal injury, permanent disability, or death. Such risks include, without limitation, bodily injury from falls, collisions, equipment failure, negligence of other participants, hazardous conditions, travel risks, and emergency situations. Participant freely and voluntarily assumes all such risks, known and unknown, whether arising from Provider's negligence or otherwise.

3. RELEASE AND WAIVER OF LIABILITY

Participant hereby releases, waives, discharges, and covenants not to sue Releasees for any and all liability, claims, demands, actions or causes of action whatsoever for any loss, damage or injury, including death, that may be sustained by Participant or to any property belonging to Participant, arising out of or related to the Activity, whether caused by the negligence of Releasees or otherwise, to the fullest extent permitted by law.

4. INDEMNIFICATION

Participant agrees to indemnify, defend and hold harmless Releasees from and against any and all claims, demands, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of Participant's negligent or intentional acts or omissions, or breach of this Agreement, including claims brought by Participant's family members, heirs or representatives.

5. MEDICAL TREATMENT; HEALTH INFORMATION

In the event of injury or medical emergency, Participant authorizes Provider and its agents to secure medical treatment and arrange transportation as deemed necessary. Participant is responsible for all costs of medical treatment and transportation. Participant represents that to the best of Participant's knowledge, Participant is in good health and physically capable of participating in the Activity.

Participant acknowledges whether they have primary medical insurance coverage: Yes No

6. REPRESENTATIONS AND WARRANTIES

Participant represents and warrants that Participant is at least 18 years of age and has full legal capacity to execute this Agreement. If Participant is under 18 years of age, a parent or legal guardian must sign this Agreement on Participant's behalf and provide the following information:

Yes — Parent/Guardian Name:

7. NO WARRANTY; COMPLIANCE

Participant acknowledges that Provider makes no express or implied warranties regarding the safety or condition of facilities, equipment or the Activity. Participant agrees to comply with all instructions, rules, safety guidelines and directions of Provider and its representatives. Failure to comply may result in termination of Participant's participation without refund.

8. NOTICES

Any notice required or permitted under this Agreement shall be in writing and delivered to the address of the receiving party set forth in this Agreement or to such other address as the party may designate by notice. Notices may be delivered in person, by certified mail, or by nationally recognized overnight courier.

9. GOVERNING LAW; VENUE

This Agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction in which the Activity primarily occurs, without regard to conflict of laws principles. Any action arising out of or relating to this Agreement shall be brought exclusively in the state or federal courts located within that jurisdiction.

10. ENTIRE AGREEMENT; SEVERABILITY

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous communications, understandings and agreements, whether oral or written. If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

11. AMENDMENT; WAIVER; COUNTERPARTS

No amendment or waiver of any provision of this Agreement shall be effective unless in writing and signed by both parties. The failure of either party to enforce any term of this Agreement shall not constitute a waiver of that term or any other term. This Agreement may be executed in counterparts, each of which shall be deemed an original, and electronic signatures shall be binding.

ACKNOWLEDGMENT

Participant certifies that Participant has carefully read this Agreement, fully understands its terms, and understands that Participant is giving up substantial rights, including the right to sue Releasees. Participant signs this Agreement voluntarily and without any inducement or assurance of any nature.

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