General Release Of Liability Form

I, ________________________________________________________ at

______________________________________________________________________________

HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES

being conducted by ________________________________________________________ at

______________________________________________________________________________

_____________________________________________________________________________,

including by way of example and not limitation, any risks that may arise from negligence or

carelessness on the part of the persons or entities being released, from dangerous or defective

equipment or property owned, maintained, or controlled by them, or because of their possible

liability without fault.

I CERTIFY that I am physically fit, have sufficiently prepared or trained for participation in this

activity, and have not been advised to not participate by a qualified medical professional. I

CERTIFY that there are no health-related reasons or problems which preclude my participation

in this activity.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event

holders, sponsors, and organizers of the activity in which I may participate, and that it will

govern my actions and responsibilities at said activity.

In consideration of my application and permitting me to participate in this activity, I hereby take

action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as

follows:

(1) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not

limited to, liability arising from the negligence or fault of the entities or persons released, for my

death, disability, personal injury, property damage, property theft, or actions of any kind which

may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING

ENTITIES OR PERSONS:

______________________________________________________________________________

and/or their directors, officers, employees, volunteers, representatives, and agents, and the

activity holders, sponsors, and volunteers;

(2) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons

mentioned in this paragraph from any and all liabilities or claims made as a result of participation

in this activity, whether caused by the negligence of release or otherwise.

I acknowledge that ____________________________________________________________

and their directors, officers, volunteers, representatives, and agents are NOT responsible for

errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on

their behalf.

I acknowledge that this activity may involve a test of a person's physical and mental limits and

carries with it the potential for death, serious injury, and property loss. The risks include, but are

not limited to, those caused by terrain, facilities, temperature, weather, condition of participants,

equipment, vehicular traffic, lack of hydration, and actions of other people, including, but not

limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not

only inherent to participants, but are also present for volunteers.

I hereby consent to receive medical treatment which may be deemed advisable in the event of

injury, accident, and/or illness during this activity.

I understand while participating in this activity, I may be photographed. I agree to allow my

photo, video, or film likeness to be used for any legitimate purpose by the activity holders,

producers, sponsors, organizers, and assigns.

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a

release and waiver to the maximum extent permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS

CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A

CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

SIGNATURES

________________________________

Releasor’s Name & Signature

________________________________

Parent/Guardian Name and Signature

(If under 18 years old, Parent or Guardian must also sign.)

________________________________ Date:

Releasee’s Name/Stamp and Signature