Liability Waiver Form

LIABILITY WAIVER AND RELEASE AGREEMENT

This Liability Waiver and Release Agreement (the Agreement) is entered into on this day: Day: Month: Year: between Provider Name: with principal address: and Participant Name: with address: (each a Party and collectively the Parties).

RECITALS

WHEREAS, Provider operates or conducts the activity described as: (the Activity), and Participant desires to participate in the Activity;

WHEREAS, the Parties desire to allocate risk and define their respective rights and obligations in connection with the Participant's participation in the Activity;

WHEREAS, Participant acknowledges that the Activity involves inherent risks, hazards, and possible injury, and is willing to assume those risks under the terms set forth herein.

NOW, THEREFORE

In consideration of the mutual promises, covenants and conditions contained in this Agreement and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the Parties agree as follows:

1. DEFINITIONS

1.1 "Activity" means the event, service or program described above and all related activities, use of facilities, equipment, travel, instruction and supervision provided by Provider. 1.2 "Released Parties" means Provider and its officers, directors, employees, volunteers, agents, contractors and affiliates.

2. ASSUMPTION OF RISK

Participant expressly acknowledges and agrees that participation in the Activity involves risks including, but not limited to, property damage, personal injury, permanent disability and death. Participant voluntarily and knowingly assumes all such risks, whether known or unknown, foreseeable or unforeseeable.

3. WAIVER AND RELEASE

In consideration of being permitted to participate in the Activity, Participant, for Participant and Participant's heirs, personal representatives, successors and assigns, hereby releases, waives, discharges and covenants not to sue the Released Parties from any and all liability, claims, demands, actions or causes of action, whether in contract, tort, statute or otherwise, arising from or related to any loss, damage, injury or death, including but not limited to negligence of any kind, resulting from Participant's participation in the Activity.

4. INDEMNIFICATION

Participant agrees to indemnify, defend and hold harmless the Released Parties from and against all claims, costs, damages, losses, liabilities, and expenses (including reasonable attorneys' fees and court costs) arising out of or related to Participant's acts or omissions in connection with the Activity, including claims by third parties.

5. REPRESENTATIONS AND WARRANTIES

Participant represents and warrants that Participant is physically fit and capable of participating in the Activity and that Participant has not been advised otherwise by a qualified medical professional. Participant will comply with all instructions, rules and safety directions provided by Provider.

6. MEDICAL AUTHORIZATION

If Participant becomes injured or ill during the Activity, Participant authorizes Provider to secure medical treatment and transportation as deemed necessary. Participant agrees to be financially responsible for such care and any related expenses.

7. INSURANCE

Participant acknowledges that Provider may not carry medical or disability insurance covering Participant and that Participant is encouraged to obtain appropriate insurance at Participant's own expense.

8. ACKNOWLEDGMENT OF UNDERSTANDING

Participant certifies that Participant has read this Agreement in its entirety, understands its contents, and is signing voluntarily and without reliance on any representations or statements other than those contained herein. Participant acknowledges that this Agreement limits Participant's rights and the rights of Participant's heirs and legal representatives.

9. NOTICES

Any notice required or permitted under this Agreement shall be in writing and delivered to the addresses set forth above or to such other address as a Party may designate by written notice to the other Party. Notices shall be deemed given upon receipt.

10. AMENDMENTS; WAIVER; COUNTERPARTS

This Agreement may be amended only by a written instrument signed by both Parties. The failure of either Party to enforce any provision shall not constitute a waiver of that provision or any other provision. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

11. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Agreement shall be governed by and construed in accordance with the laws of the state selected by Provider: without regard to conflicts of law principles. This Agreement constitutes the entire agreement between the Parties concerning the subject matter hereof and supersedes all prior agreements and understandings. If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

PARTICIPANT INFORMATION

Day: Month: Year:

ACKNOWLEDGMENTS

I acknowledge that I have carefully read this Agreement, fully understand its terms, and understand that I am giving up substantial legal rights, including my right to sue the Released Parties. I acknowledge that I am signing this Agreement freely and voluntarily.

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