Sample Participant Waiver of Liability Form

PARTICIPANT WAIVER AND RELEASE OF LIABILITY,
ASSUMPTION OF RISH AND INDEMNITY AGREEMENT
I, for myself, and on behalf of my spouse, children, guardians, heirs and next of kin, and
any legal and personal representatives, executors, administrators, successors and assigns, hereby
agree to and make the following contractual representations pursuant to this Waiver and Release
of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”);
1. I hereby represent that (i) I am at least eighteen (18) years of age or older; (ii) I am in
good health and in proper physical condition to participate in our activities; and (iii) I am not
under the influence of alcohol or any illicit or prescription drugs which would in any way impair
my ability to safely participate in our activities. I agree that it is my sole responsibility to
determine whether I am sufficiently fit and healthy enough to participate in the activities, that I
am responsible for my own safety and well-being at all times and under all circumstances while
at our activity site.
2. I understand and acknowledge that participation in our activities is inherently dangerous

and represents an extreme test of a person’s physical and mental limits. I understand and
acknowledge the risks and dangers associated with participation in our activities and related
activities, including without limitation, the potential for serious bodily injury, sickness and
disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/
property; exposure to extreme conditions and circumstances; contact with other participants,
spectators, animals or other natural or manmade objects; dangers arising from adverse weather
conditions; imperfect course or track conditions; land, water and surface hazards; equipment
failure; inadequate safety measures; participants of varying skill levels; situations beyond the
immediate control of the Activity Organizers; and other undefined, not readily foreseeable and
presently unknown risks and dangers (“Risks”). I understand that these Risks may be caused in
whole or in part by my own actions or inactions, the actions or inactions of others participating in
the activities, or the negligent acts or omissions of the Released Parties defined below, and I
hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or
expenses which I incur as a result of my participation in any activity.
3. I agree to be familiar with and to abide by the Rules and Regulations established for the
activities, including but not limited to the rules adopted by us and any safety regulations
established for the benefit of all participants. I accept sole responsibility for my own conduct and
actions while participating in our activities, and the condition and adequacy of my equipment.
4. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and
Hold Harmless the following parties: NAME HERE, Inc., and Promoters, Sponsors,
Advertisers, Coaches and Officials; the Host Organization and the Facility, Venue and Property
Owners or Operators upon which the activities takes place; Law Enforcement Agencies and
other Public Entities providing support for the Event; and each of their respective parent,
subsidiary and affiliated companies, officers, directors, partners, shareholders, members, agents,
employees and volunteers (Individually and Collectively, the “Released Parties” or “Event
Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s),
loss or expense (including court costs and reasonable attorneys’ fees) of any kind or nature
(“Liability”) which may arise out of, result from, or relate in any way to my participation in the
activities, including claims for Liability caused in whole or in part by the negligent acts or
omissions of the Released Parties. I further agree that if, despite this Agreement, I, or anyone on
my behalf, makes a claim for Liability against any of the Released Parties, I will indemnify,
defend and hold harmless each of the Released Parties from any such Liabilities which any may
be incurred as the result of such claim. I hereby warrant that I am of legal age and competent to
enter into this Agreement, that I have read this Agreement carefully, understand its terms and
conditions, acknowledge that I will be giving up substantial legal rights by signing it (including
the rights of my spouse, children, guardians, heirs and next of kin, and any legal and personal
representatives, executors, administrators, successors and assigns), acknowledge that I have
signed this Agreement without any inducement, assurance or guarantee, and intend for my
signature to serve as confirmation of my complete and unconditional acceptance of the terms,
conditions and provisions of this Agreement. This Agreement represents the complete
understanding between the parties regarding these issues and no oral representations, statements
or inducements have been made apart from this Agreement. If any provision of this Agreement is
held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed
severable from this Agreement and shall not affect the validity and enforceability of any
remaining provisions.
Print Name: _____________________ Age: ______ Date of Birth: _______/_______/________
Home Address:
___________________________________________________________________________
Home Tel.: (_____) _________________
Signature _____________________________________________________
Dated_______/_______/____________
On Behalf of minor(s):
I am the parent (or legal guardian) of the below listed minors and executing this document on
their behalf. Furthermore, I assume all responsibility and liability as stated above.
Print Name: ____________________________ Age: ______ Date of Birth:____/______/20___
Date: _____/____/_____
Signature: _____________________________________________________
Date: _____/____/_____
Signature: _____________________________________________________
Date: _____/____/_____
Signature: _____________________________________________________

Sample Participant Waiver of Liability Form

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Sample Participant Waiver of Liability Form

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PARTICIPANT WAIVER AND RELEASE OF LIABILITY,

ASSUMPTION OF RISH AND INDEMNITY AGREEMENT

2. I understand and acknowledge that participation in our activities is inherently dangerous

Print Name: _________________ Age: Date of Birth: _/_/______

Print Name: ______________________ Age: Date of Birth://20_

Print Name: ______________________ Age: Date of Birth://20_

Print Name: ______________________ Age: Date of Birth://20_

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