#BuckeyeBetter
Name of Volunteer (please print):
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email:
example@example.com
In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree to the following:
1.) I am donating my time and services without any compensation and shall at no time be co sidered an employee or independent contractor of Buckeye Water to Trail Adventures LLC.
2.) I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of releases or others, and assume full responsibility for my participation.
3.) I willingly agree to comply with the terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official.
4.) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release indemnify, and hold harmless Buckeye Water to Trail Adventures LLC and it's officers, agents and/or employees, other participants, sponsors, advertisers, partners, and,if applicable, owners and lessors of premises used to conduct the event (RELEASES), from any and all claims, demands, losses, and liability arising out of or related to any injury, disability, or death I may suffer, or loss or damage to person or property, whether arising from the negligence of the releases or otherwise; to the fullest extent permitted by law.
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5.) Any dispute between Buckeye Water to Trail Adventures and me will be governed by the substantive laws of the State of Ohio. Any action or proceeding arising hereunder shall be brought in the courts of the State of Ohio.
6.) I grant Buckeye Water to Trail Adventures LLC, it's representatives and employees the right to take photographs at this cleanup of me and of any minor participants for which I am the legal parent or guardian. I authorize Buckeye Water to Trail Adventures LLC, its assigns and transferees to use such photographs, with or without names, for any lawful purposes, including for example such purpose as publicity, illustration, advertising, and web content, and to copyright, use and publish the same in print and/or electronically.
I have read this release of liability and assumption of risk agreement, fully understand it's terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.
Full Name (please print)
First Name
Last Name
Participant Signature
Date:
-
Month
-
Day
Year
Date
Emergency contact:
FOR PARENTS AND GUARDIANS OF PARTICIPANT OF MINOR AGE (under age 18 time of registration)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all releases, and for myself, my heirs, assigns, and next of kin. I release and agree to indemnify and hold harmless the Releases from any and all liability incidents to my minor child's involvement or participation in these programs as provided above, EVEN ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by law.
Full Name
First Name
Last Name
Parent/Guardian signature
Date:
-
Month
-
Day
Year
Date
Emergency contact:
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