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    CXYS Liability Form

    Uploaded by

    Randy Nissen
    This document is a liability waiver and photo release form for beach and land volunteers. It consists of: 1) A waiver releasing the State of Ohio and other parties from liability for any personal injury or wrongful death suffered during volunteer activities. 2) An agreement to indemnify and hold harmless the described entities from any legal claims or causes of action arising from engaging in the volunteer activities. 3) Fields to provide the volunteer's name, organization, phone, email, signature and emergency contact information. Participants under 18 require a parent/guardian signature.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    CXYS Liability Form

    Uploaded by

    Randy Nissen
    68 views1 page
    This document is a liability waiver and photo release form for beach and land volunteers. It consists of: 1) A waiver releasing the State of Ohio and other parties from liability for any personal injury or wrongful death suffered during volunteer activities. 2) An agreement to indemnify and hold harmless the described entities from any legal claims or causes of action arising from engaging in the volunteer activities. 3) Fields to provide the volunteer's name, organization, phone, email, signature and emergency contact information. Participants under 18 require a parent/guardian signature.

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    Liability form

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    This document is a liability waiver and photo release form for beach and land volunteers. It consists of: 1) A waiver releasing the State of Ohio and other parties from liability for any personal injury or wrongful death suffered during volunteer activities. 2) An agreement to indemnify and hold harmless the described entities from any legal claims or causes of action arising from engaging in the volunteer activities. 3) Fields to provide the volunteer's name, organization, phone, email, signature and emergency contact information. Participants under 18 require a parent/guardian signature.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    68 views1 page

    CXYS Liability Form

    Uploaded by

    Randy Nissen
    This document is a liability waiver and photo release form for beach and land volunteers. It consists of: 1) A waiver releasing the State of Ohio and other parties from liability for any personal injury or wrongful death suffered during volunteer activities. 2) An agreement to indemnify and hold harmless the described entities from any legal claims or causes of action arising from engaging in the volunteer activities. 3) Fields to provide the volunteer's name, organization, phone, email, signature and emergency contact information. Participants under 18 require a parent/guardian signature.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Everyone needs a release form - If you are over 18 you can sign your own.

    For Office Use Only


    ** COPY AND USE BOTH SIDES **

    ALL BEACH/LAND VOLUNTEERS MUST READ, SIGN & DATE


    I,
    , acknowledge that by signing this release I exempt the
    State of Ohio and its employees, Coastweeks Committee members, sponsoring organizations and all other
    volunteers from liability for personal injury suffered or wrongful death, whether or not negligently caused
    during any Coastweeks activity.
    For and in consideration of the mutual promises made hereby and herein, I voluntarily release, discharge,
    and relinquish any and all actions or causes of action arising as a result of the activities on the date noted
    hereunder.
    I also release on behalf of myself, my heirs, executors, administrators, and assigns any entity(ies) from any
    and all causes of action; and further for myself and my heirs, executors, administrators, and assigns, I do
    hereby release, waive, discharge, and relinquish any action or causes of action which may hereafter arise
    for myself, and for my estate, and agree that under no circumstances will I or my heirs, executors,
    administrators, and assigns prosecute, present any claims against aforementioned persons and entities for
    personal injury, property damage, or wrongful death, whether or not negligently caused.
    I, for myself, my heirs, executors, administrators or assigns agree that in the event any claim for personal
    injury, property damage, or wrongful death shall be prosecuted against the herein described entities, I shall
    indemnify and hold it or each of them harmless from any and all claims or causes of action by whomever or
    wherever made or presented for personal injury, property damage, or wrongful death.
    I acknowledge that I have read the foregoing paragraphs, have been fully advised of the potential dangers
    incidental to engaging in the activity, and am fully aware of the legal consequences of signing this
    instrument.
    I specifically waive any claim or right to assert same in any cause of action, alleged caused of action, claim
    or demand that has been, through oversight or error, intentional or unintentional, omitted from this release.
    By signing below, I hereby grant to the Partners for Clean Streams, Inc. and to its employees, agents and
    assigns the right to photograph me and/or my dependent and use the photo and or other digital
    reproduction of me/him/her or other reproduction of my/his/her physical likeness for publication processes,
    whether electronic, print, digital or electronic publishing via the Internet.
    PARTICIPANT NAME*:
    ORGANIZATION* (if any):

    (One form per participant)

    Toledo Early College

    PHONE*:
    E-MAIL:
    SIGNATURE of Participant*:

    Date:

    SIGNATURE of Parent/Guardian* (if under 18):

    Date:

    EMERGENCY CONTACT INFORMATION DAY OF EVENT:


    NAME:
    PHONE:
    Please check the box if participant is a minor

    *Required field

    Bring with you to kickoff registration on the morning of the event.


    Partners for Clean Streams, PO Box 203, Perrysburg, OH 43552

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