Accident Waiver And Release Of Liability Form printable pdf download

Old Stage Rd • Colorado Spgs, CO 80906

(719) 632-0740 •

ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM

NAME OF PARTICIPANT: ______________________________________

DATE(S) OF EVENT: ________________________

NAME OF EVENT: _____________________________

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS ACTIVITY OR EVENT,

including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of Foundation of

the Heart, a Colorado nonprofit corporation, and/or its directors, officers, servants, agents, representatives and employees and the

United States Department of Agriculture-Forest Service-Pike National Forest (USDA/FS) (collectively and individually “Released

Parties”), regardless of their negligent acts or omissions.

I certify that I am physically fit, and am prepared for participation in the activity or event, 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 or event.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by Released Parties and that it will govern my

actions and responsibilities at said activity or event and on the Bear Trap Ranch premises.

In consideration of my application and permitting me to participate in this activity or event, I hereby take action for myself, my

executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, claims, demands, actions and causes of action whatsoever

arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to

me, while participating in any conference/project related activity, or while on or upon the premises of the Bear Trap Ranch where the

conference or event is being conducted, including but not limited to, liability arising from the negligence or fault of the Released

Parties, 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 or event; and

(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the Released Parties from and for any and all liabilities or

claims made as a result of participation in this activity or event, whether caused by the negligence of any of the Released Parties or

otherwise. It is my expressed intent that this release, hold harmless and indemnification agreement shall bind the members of my

family and spouse (if applicable), if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be

deemed as a RELEASE, WAIVER, DISCHARGE, and CONVENTION TO SUE the Released Parties. I hereby further agree that this

Waiver of Liability and Hold Harmless Agreement shall be constructed in accordance with the laws of the State of Colorado.

I acknowledge that the Released Parties are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity

conducting a specific event or activity.

I acknowledge that this activity or event may involve risk (both man-made and natural) that may carry with it the potential for death,

serious injury, and property loss. The risks may include, but are not limited to, those caused by natural mountain terrain, facilities,

equipment, temperature, weather, condition of participants, animals, insects, vegetation, unmarked trails, altitude, adventure activities,

actions of other people including, but not limited to, other participants, volunteers, sponsors and/or producers of the event, and lack of

hydration.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during

this activity or event. I release and discharge Released Parties from any liability for any first aid rendered and for any medical

assistance obtained for me pursuant to this permission.

I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be

used for any legitimate purpose by the Released Parties or other event holders, producers, sponsors, organizers, and assigns.

Accident Waiver And Release Of Liability Form