In consideration for being allowed to voluntarily participate in the above-referenced activities, on behalf of myself, my personal representatives, heirs, next of kin, successors and assigns, I forever:
a) waive, release, and discharge Communication Cottage Therapy, LLC and its agencies, officers, and employees from any and all negligence and liability for my death, disability, personal injury, property damages, property theft or claims of any nature which may hereafter accrue to me, and my estate as a direct or indirect result of my participation in the above referenced activity or event; and
b) agree to defend, indemnify, and hold harmless Communication Cottage Therapy LLC, its agencies, officers and employees, from and against any and all claims of any nature including all costs, expenses and attorneys’ fees, which in any manner result from participant’s actions during this activity or event.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident or illness during this activity or event. This release, indemnification, and waiver shall be construed broadly to provide a release, indemnification, and waiver to the maximum extent permissible under applicable law.
I, the undersigned participant, affirm that I am at least 18 years of age and am freely signing this agreement.
I have read this form and fully understand that by signing this form I am giving up legal rights and/or remedies which may otherwise be available to me regarding any losses I may sustain as a result of my participation. I agree that if any portion is held invalid, the remainder will continue in full legal force and effect.