Sample Liability Disclaimer Form
Liability disclaimer form is used by any participating party who recognizes the risk involved in certain activities, thus releasing the liability of damage or injuries during the course of work involved. Below is useful smaple disclaimer form to be used:
======================================
For
[ACTIVITY]
The [PROVIDER] does not provide liability insurance for the protection
of individuals, groups, organizations, businesses, spectators, or
others who may participate in the [ACTIVITY].
In consideration for your participation in said [ACTIVITY], the
individual, group, organization, business, spectator, or other, does
hereby release and forever discharge the [PROVIDER], and its officers,
board, and employees, jointly and severally from any and all actions,
causes of actions, claims and demands for, upon or by reason of any
damage, loss or injury, which hereafter may be sustained by
participating in the [ACTIVITY].
This release extends and applies to, and also covers and includes, all
unknown, unforeseen, unanticipated and unsuspected injuries, damages,
loss and liability and the consequences thereof, as well as those now
disclosed and known to exist. The provisions of any state,
federal, local or territorial law or state providing substance that
releases shall not extend to claims, demands, injuries, or damages
which are known or unsuspected to exist at this time, to the person
executing such release, are hereby expressly waived.
I hereby agree on behalf of my heirs, executors, administrators, and
assigns, to indemnify the [PROVIDER] and its officers, board and
employees, joint and severally from any and all actions, causes of
actions, claims and demands for, upon or by reason of any damage, loss
or injury, which hereafter may be sustained by participating in the
[ACTIVITY].
It is further understood and agreed that said participation in the
[ACTIVITY]is not to be construed as an admission of any liability and
acceptance of assumption of responsibility by the [PROVIDER], its
officers, board, and employees, jointly and severally, for all damages
and expenses for which the [PROVIDER], its officers, board and
employees, become liable as a result of any alleged act of the parade
participant.
_________________ __________________________________
Name of Organization
Name of Individual Responsible
(Print)
_________________
_________________
Address
Phone
_________________
_________________
Signature
Date
All participants must complete this Liability Disclaimer to be eligible
to participate in the parade.
Return completed form with Entry Form to:
[ADDRESS]