Liability Waiver Packet

LIABILITY WAIVER PACKET

Recitals

WHEREAS, Provider Name: operates, organizes, or sponsors certain activities, events, programs, and/or services described below; and

WHEREAS, Participant Name: desires to participate in the activity identified in this packet and acknowledges that participation may involve risk of injury, illness, or property damage; and

WHEREAS, the parties wish to set forth the terms under which Participant will participate and the allocation of risk between the parties.

Activity and Scope of Participation

Participant Information

Emergency Contact

Acknowledgement of Risk and Assumption of Liability

I, the undersigned Participant, acknowledge that participation in the activity described above involves inherent risks including but not limited to personal injury, property damage, illness, and death. I freely and voluntarily assume all risks associated with my participation, whether known or unknown, foreseeable or unforeseeable.

I certify that I am physically fit, have no medical condition that would prevent my safe participation, and will immediately notify Provider in writing of any change in my health or physical condition that may affect my ability to participate safely.

Release, Waiver and Indemnification

In consideration of being permitted to participate, I, on behalf of myself, my heirs, assigns, personal representatives and next of kin, release, waive, surrender, and discharge Provider, its owners, directors, officers, employees, volunteers, agents, affiliates and insurers (collectively "Released Parties") from any and all claims, demands, liabilities, losses, suits, damages, costs and expenses, including attorney fees, arising out of or related to my participation, whether caused by the negligence of the Released Parties or otherwise, to the fullest extent permitted by law.

I agree to indemnify and hold harmless the Released Parties from and against any and all claims, liabilities, damages, losses and expenses (including attorney fees) arising from my negligent or intentional acts or omissions while participating in the activity.

Medical Authorization & Special Health Information

In the event of an emergency, I authorize Provider to secure medical treatment and transportation as deemed necessary, and I authorize medical personnel to provide treatment. I agree to be financially responsible for any medical services rendered on my behalf.

Acknowledgements and Additional Consents

I have read this Liability Waiver Packet in its entirety, I understand its terms, and I am signing it voluntarily. I understand that by signing I am giving up substantial legal rights.

I consent to the use of photographs or recordings taken during the activity by Provider for promotional or educational purposes without compensation, unless I have indicated otherwise below.

I do NOT consent to the use of my image and request that Provider not use any photographs or recordings of me.

Minor Participant — Parent/Guardian Consent (if applicable)

If Participant is under 18 years of age, the undersigned parent or legal guardian certifies that they are authorized to consent on behalf of the minor and agrees to the terms of this Waiver and Release. The parent/guardian further agrees to indemnify the Released Parties from any claims brought by or on behalf of the minor.

Term, Governing Law and Miscellaneous

This Waiver and Release is effective as of the date signed and applies to the activity dates set forth above and any associated sessions, including any extensions or renewals unless expressly revoked in writing by Provider. Participant acknowledges that this Waiver survives the completion of the activity.

Governing Law: This Waiver will be governed by and construed in accordance with the laws of the state of without regard to conflict of law principles.

Severability: If any provision of this Waiver is held invalid or unenforceable, the remaining provisions shall continue in full force and effect.

Entire Agreement: This document constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous understandings, agreements, representations, and warranties, whether written or oral.

Optional Fees and Administrative Information

If any administrative or participation fees apply, Participant acknowledges responsibility for payment according to the applicable schedule provided separately. Failure to pay may result in suspension of participation and collection action for outstanding balances.

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