Waiver of Liability- Upper Allen Township

Upper Allen Township

Waiver and Release of Liability
I voluntarily visit the Upper Allen Township Wastewater Treatment Plant facility with full knowledge of all that is involved and I agree to assume any and all risks associated with injury and/or property damage whether the risks are known or unknown and acknowledge, appreciate, and agree that:

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Upper Allen Township and the Upper Allen Township Sewer Department, their officers, officials, agents and/or employees, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with my presence or participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, unless attributable to the willful or gross negligence of said employees.

I HAVE READ THIS RELEASE OF LIABILITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Participant Name*

First NameLast Name
Participant Age*
Participant Signature*

Clear
Date Signed*

MonthDayYear
If you would like a copy of this waiver emailed to you, provide your email address. (optional)
Participant Email Address
Completed waivers go to
Should be Empty: