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Release of Liability Template

Prepared for:

[Client.FirstName][Client.LastName]
[Client.Company]

Created by:

[Sender.FirstName][Sender.LastName]
[Sender.Company]

I, [Participant.FirstName][Participant.LastName] for consideration of participating in the activity [Activity.Name] taking place on the following date [Date] hereby release [Company.Name] from any and all liabilities that may occur from injury or loss during this activity [Activity.Name].

Agreement to follow directions

I hereby acknowledge that I have read or otherwise received all rules, warnings, and restrictions related to [Activity.Name].

I hereby certify that I understand the above risks associated with this [Activity.Name] and agree that [Company.Name] shall not be responsible for any injuries or losses sustained by me during activity [Activity.Name]

Additionally, I agree to be held solely responsible if my negligence, willful misconduct, or disregard for the rules of [Activity.Name] leads to damage to others or to [Company.Name] property.

Any legal manners arising from this release of liability shall take place in the state of [State.Name] as agreed.

Assumption of the risk and release

I am in complete understanding of the risks associated with this event [Event.Name] or activity [Activity.Name] including, but not limited to, the following:

  • Broken bones
  • Sprained ankles
  • Back injury
  • Brain injury
  • Skull fracture
  • Concussion
  • Torn ligaments
  • Cuts and bruises
  • Finger injuries
  • Other_________

Indemnification

I agree to hold harmless and indemnify and defend [Company.Name] against all claims, causes of action, damages, judgments, costs, property damage, or expenses including attorneys’ fees and other litigation which in any way arise from my own or, if applicable, my family’s use of or presence upon the facilities of [Company.Name] during [Event.Name] while participating in said [Activity.Name].

No Duress

I agree and acknowledge that I am under no pressure or duress to sign this liability waiver and that I have been given a reasonable opportunity to review this general release of liability form. I acknowledge that any deposit monies will be refunded and that I may not be able to participate in [Activity.Name] if I choose not to sign this waiver. I consent that I understand that participation in this activity is voluntary.

Emergency Contact

In case of emergency, please call [Emergency Contact.Name] who is my [Relationship] at the following number: [Cell.Home.Number]  

Acceptance

I accept this release of liability as the complete terms between myself and [Company.Name] while participating in [Event.Name].

BY SIGNING BELOW, BOTH PARTIES AGREE TO THE TERMS CONTAINED WITHIN THIS AGREEMENT AND ACKNOWLEDGE UNDERSTANDING OF THE TERMS AND CONDITIONS CONTAINED HEREIN INCLUDING THE VOLUNTARY SURRENDER OF CERTAIN LEGAL RIGHTS. 

[Participant.FirstName][Participant.LastName]

Signature

MM/DD/YYYY

[Company.Name]

Signature

MM/DD/YYYY

[CompanyAgent.FirstName][CompanyAgent.LastName]

[CompanyAgent.Title]

Optional Parent/Guardian Release

I/We [Parent.Name(s)], the parents of [Participant.FirstName][Participant.LastName] who is at the date of signing a minor under the age of eighteen (18) years, have read the above agreement and acknowledge that both we and our son/daughter have entered into this agreement with an understanding of its terms and conditions as listed above. 

[Sender.Company]

Signature

MM/DD/YYYY

[Sender.FirstName][Sender.LastName]

[Client.Company]

Signature

MM/DD/YYYY

[Client.FirstName][Client.LastName]

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