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General Release Form

The document is a release and waiver of liability form for an individual named Tacepnie KIANOLO to participate in an unspecified activity. It acknowledges the risks involved in the activity and releases the company or person providing the activity from any legal claims arising from injuries sustained during participation. The individual agrees to assume the risks and waives any right to make claims against the releasee, except for gross negligence or willful misconduct. The release constitutes the entire agreement between the parties and is governed by the laws of the unspecified state.

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42 views

General Release Form

The document is a release and waiver of liability form for an individual named Tacepnie KIANOLO to participate in an unspecified activity. It acknowledges the risks involved in the activity and releases the company or person providing the activity from any legal claims arising from injuries sustained during participation. The individual agrees to assume the risks and waives any right to make claims against the releasee, except for gross negligence or willful misconduct. The release constitutes the entire agreement between the parties and is governed by the laws of the unspecified state.

Uploaded by

x-emotionalxgirl
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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RELEASE AND WAIVER OF LIABILITY FORM

1. Parties and Liability Event.


The individual named below (referred to as "I" or "me") desires to participate in the following activity
(the "Activity"):
________Tacepnie
KIANOLO_________________________________________________________________________
___________________________________________________________________________________
______________________________________________________.

The Activity will be provided by ______________________________(company name / person name),


a ______________________________(state of organization)____________________________(entity
type)(the "Releasee") at the following address:
___________________________________________________________________________________
___________________________________________________________________________________
____________________________________________________.

In consideration of being permitted by the Releasee to engage in the Activity and in recognition of the
Releasee’s reliance hereon, I _____Tacepnie KIANOLO_______________________(name of
releasor) agree to all the terms and conditions set forth in this agreement (this "Release").

2. Assumption of Risk.
I am aware and understand that the Activity is a potentially dangerous activity and involves the risk of
injury, disability, death, or property damage. I acknowledge that these risks may result from or be
compounded by the actions, omissions, or negligence of the Releasee, its employees, or others,
including negligent emergency response or rescue operations of the Releasee. I understand that while
the Releasee has implemented measures to reduce the risk of injury from the Activity, the Releasee
cannot guarantee that I will not be injured due to my participation in the Activity.
NOTWITHSTANDING THESE RISKS, I ACKNOWLEDGE THAT I AM VOLUNTARILY
PARTICIPATING IN THE ACTIVITY WITH KNOWLEDGE OF THE DANGERS INVOLVED.

3. Release.
I hereby expressly waive and release any and all claims, now known or hereafter known, against the
Releasee, and its employees, agents, affiliates, successors, and assigns (collectively, "Releasees"), on
account of injury, illness, disability, death, or property damage arising out of or attributable to my
participation in the Activity, whether arising out of the ordinary negligence of the Releasees or
otherwise.

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I covenant not to make or bring any such claim against the Company or any other Releasee and forever
release and discharge the Releasee and all other Releasees from liability under such claims. This waiver
and release does not extend to claims for gross negligence, willful misconduct, or any other liabilities
that relevant state law does not permit to be released by agreement.

4. Consideration.
The parties agree to the following: (please check one)

☐ The Releasee shall not pay the Releasor to be released from any liability.

☐ IN CONSIDERATION OF the payment of $ ________________, paid by the Releasee to the


Releasor, the receipt of which is acknowledged, the Releasor releases and forever discharges the
Releasee from all manner of legal actions and claims. I understand that this payment is made in full
settlement of any action, claim, and demand that may be brought as a result of sustaining any loss,
damage, or injury.

5. Entire Agreement and Binding Effect.


This Release constitutes the sole and entire agreement of the Releasee and me with respect to the
subject matter contained herein and supersedes all prior and contemporaneous understandings,
agreements, representations, and warranties, both written and oral, with respect to such subject matter.
If any term or provision of this Release is invalid, illegal, or unenforceable in any jurisdiction, such
invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or
invalidate or render unenforceable such term or provision in any other jurisdiction.
This Release is binding on and shall inure to the benefit of the Releasee and me and our respective
successors and assigns. All matters arising out of or relating to this Release shall be governed by and
construed in accordance with the internal laws of the State of __________________.

Releasor’s Signature: _______Tacepnie KIANOLO__________________________ Date


______03/10________
Print Name: _________________________________

Releasee’s Signature: _________________________________ Date ______________

Print Name: _________________________________

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