(Needs a Monday Board) Release of Liability Form

Release of Liability

This form must be submitted for access to all events sponsored, supported or provided by Inclusion Fusion NW
Participants Name

First NameLast Name
Date begin

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
In consideration of being allowed to participate in activities and events organized by Inclusion Fusion NW, I, the undersigned, agree to the following terms and conditions:

Assumption of Risk: I understand that participation in activities and events organized by Inclusion Fusion NW involves inherent risks, including but not limited to physical injury, illness, property damage, or death, and I voluntarily assume all such risks.
Release of Liability: I hereby release, waive, discharge, and covenant not to sue Inclusion Fusion NW, its directors, officers, employees, volunteers, agents, representatives, successors, and assigns (collectively referred to as “Releasees”) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including but not limited to bodily injury, illness, or property damage, that may be sustained by me or to any property belonging to me, whether caused by the negligence of the Releasees or otherwise, while participating in activities or events organized by Inclusion Fusion NW.
Indemnification: I agree to indemnify, defend, and hold harmless the Releasees from and against any and all liability, claims, demands, actions, damages, costs, and expenses (including reasonable attorney fees) arising out of or related to my participation in activities or events organized by Inclusion Fusion NW.
Medical Treatment: I authorize Inclusion Fusion NW and its representatives to consent to emergency medical treatment for me if necessary, and I agree to be responsible for all costs associated with such treatment.
Media Release: I grant Inclusion Fusion NW the irrevocable right and permission to use photographs, audio recordings, and/or video recordings of me taken during activities or events organized by Inclusion Fusion NW for promotional purposes.
Governing Law: This Release of Liability Form shall be governed by and construed in accordance with the laws of the state of Oregon, without giving effect to any principles of conflicts of law.
Severability: If any provision of this Release of Liability Form is held to be invalid or unenforceable, the remaining provisions shall continue to be valid and enforceable to the fullest extent permitted by law.
I have read this Release of Liability Form, fully understand its terms, and understand that I have given up substantial rights by signing it. I voluntarily sign my name to indicate my agreement to its terms.

This document is good for all events or until written notice is Provided to Inclusion Fusion NW.
Parent/Guardian or Self (by signing you attest that you have the legal authority to sign)

First NameLast Name
Today's Date

MonthDayYear
Date
Responsible party Signature

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