Request For Waiver
I. Introduction
Welcome to [YOUR COMPANY NAME]. Before you participate in any activities, we require that you sign this Waiver of Liability Agreement. This document outlines key points regarding your participation and the risks involved, ensuring you are fully informed.
II. Participant Information
Please provide your accurate personal information as requested below:
Name: [PARTICIPANT NAME]
Date of Birth: [DATE OF BIRTH]
Contact Information: Phone Number [PHONE NUMBER], Email [EMAIL ADDRESS]
III. Acknowledgment of Risks
By signing this agreement, you, [PARTICIPANT NAME], acknowledge that the activities you will be participating in can include potential risks, including but not limited to personal injury, property damage, and other forms of loss. You declare that you voluntarily agree to participate and assume all related risks.
IV. Terms and Conditions
As a participant, you agree to abide by all terms and conditions set by [YOUR COMPANY NAME].
You will follow all guidelines and instructions given by the activity leaders and staff.
You agree to wear appropriate gear and follow safety measures.
You will inform the staff of any medical conditions that may affect your ability during the activities.
V. Waiver Release
By entering into this agreement, you release [YOUR COMPANY NAME] and its employees from any claims, demands, and causes of action due to any injury, loss, or damage that you might sustain as a result of participating in these activities.
VI. Emergency Contact Information
Please provide your emergency contact details:
Name: [EMERGENCY CONTACT NAME]
Relationship: [RELATIONSHIP WITH PARTICIPANT]
Contact Number: [EMERGENCY CONTACT NUMBER]
VII. Consent and Approval
By signing below, you affirm that the information provided in this Waiver of Liability Agreement is accurate, and you consent to the terms laid out above. Moreover, you affirm that your participation is completely voluntary and that you have had the opportunity to ask questions about this agreement.
VIII. Legal Considerations
This Waiver of Liability Agreement is governed by the laws of the state or region where [YOUR COMPANY NAME] operates. This waiver serves as the entire agreement between the participant and [YOUR COMPANY NAME], superseding any prior oral or written agreements.
IX. Signature
I, [PARTICIPANT NAME], fully understand and agree to the terms of this Waiver of Liability Agreement.
Participant Signature: ___________________________
Date: [DATE]
For [YOUR COMPANY NAME],
Authorized Signatory: ___________________________
Position: [YOUR POSITION]
Date: [DATE]
Thank you for your cooperation and participation. We hope you have a safe and rewarding experience with us at [YOUR COMPANY NAME].
For any questions or further information, please contact us using the details below:
Email: [YOUR COMPANY EMAIL]
Phone: [YOUR COMPANY NUMBER]
Address: [YOUR COMPANY ADDRESS]
Website: [YOUR COMPANY WEBSITE]
Social Media: [YOUR COMPANY SOCIAL MEDIA]
Waiver Templates @ Template.net
