This responsibility waiver form template has 2 pages and is a MS Word file type listed under our legal agreements documents.
Sample of our responsibility waiver form template:
RESPONSIBILITY WAIVER FORM EVENT / ACTIVITY Name: __________________________________________ Date: __________________________________________ Location: _______________________________________ PARTICIPANT INFORMATION Name: __________________________________________ Address: ________________________________________ City, State, ZIP: ________________________________ Phone: __________________________________________ Email: ___________________________________________ EMERGENCY CONTACT INFORMATION Name: __________________________________________ Relationship: ____________________________________ Phone: __________________________________________ WAIVER AND RELEASE OF LIABILITY In consideration of being allowed to participate in the above-described event or activity, I, the undersigned, acknowledge, appreciate, and agree that: Assumption of Responsibility: I understand that participating in the event/activity involves personal responsibility. I agree to act responsibly and follow all rules and instructions provided by the organizers. Release from Responsibility: I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, hereby release, indemnify, and hold harmless [ORGANIZATION NAME], its officers, officials, agents, and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releasees"), from any and all claims, demands, losses, and liability arising out of or related to any incident, whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law.
