ACTIVITY WAIVER AND RELEASE FORM TEMPLATE

This Activity Waiver and Release Form (“Agreement”) is entered into on [Date], by and between:

Organizer/Provider:
Name: [Full Legal Name / Organization]
Address: [Address]
Phone: [Phone Number]
Email: [Email Address]

Participant:
Name: [Full Legal Name]
Date of Birth: [MM/DD/YYYY]
Address: [Address]
Phone: [Phone Number]
Email: [Email Address]

1. Acknowledgment of Risks

The Participant acknowledges and fully understands that participation in [Activity/Event Name] involves certain risks, hazards, and dangers, including the risk of injury, illness, or property damage. The Participant voluntarily assumes all such risks.

2. Release of Liability

The Participant hereby releases, waives, and discharges the Organizer, its employees, agents, and representatives from any and all claims, liabilities, or demands arising out of or related to participation in the activity, whether caused by negligence or otherwise.

3. Indemnification

The Participant agrees to indemnify and hold harmless the Organizer from any loss, liability, damage, or cost, including attorney’s fees, arising out of the Participant’s involvement in the activity.

4. Medical Authorization

In the event of an emergency, the Participant authorizes the Organizer to secure medical treatment deemed necessary. The Participant agrees to bear any related medical expenses.

5. Governing Law

This Agreement shall be governed by the laws of [State/Country].

6. Entire Agreement

This document contains the entire understanding between the Parties and supersedes all prior agreements or representations, whether written or oral.

7. Signatures

Participant:
Signature: _________________________
Name:
Date:

Organizer/Provider Representative:
Signature: _________________________
Name:
Title:
Date:

If Participant is under 18 years of age, a parent or guardian must sign below:

Parent/Guardian:
Signature: _________________________
Name:
Date:

[Optional Attachments]

☐ Safety Guidelines for Activity
☐ Schedule of Event/Activity Details
☐ Insurance Information