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Liability Waiver & Release
Participant Name
Alexandra Chen
Date of Birth
03/15/1996
Address
Emergency Contact
Activity / Event
Date: | Location: See above
Assumption of Risk
I acknowledge that participation in the above-described activity involves inherent risks, including but not limited to physical injury, disability, and death. I understand that these risks may result from my own actions, the actions of other participants, or conditions of the activity area. I voluntarily assume all such risks, both known and unknown, even if arising from the negligence of the releasees.
Waiver & Release of Liability
In consideration of being permitted to participate in the above activity, I hereby release, waive, discharge, and covenant not to sue , its officers, employees, agents, and volunteers from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, or injury that may be sustained by me during or as a result of participation in said activity.
Medical Authorization
I authorize the organization to secure emergency medical treatment for the participant if needed. I understand that I am financially responsible for any medical expenses incurred. I confirm that the participant has no known medical conditions that would prevent safe participation, unless disclosed below.
I have read this waiver and release of liability in its entirety. I fully understand its terms and conditions. I understand that I am giving up substantial rights, including my right to sue. I sign this agreement freely and voluntarily without any inducement.
Initials:
Participant Signature
Date
Printed Name
Phone