WAIVER AND RELEASE OF LIABILITY FOR GPN PROGRAMS

EXHIBIT B

WAIVER AND RELEASE OF LIABILITY FOR GPN PROGRAMS
In exchange for use of the property/facilities of Great Park Neighborhoods Community Association (“GPN”) at Irvine, CA, I, on behalf of myself, and/or as the parent/guardian for FULL NAME* (“Member Participant”), of * agree to the following:
I/Member Participant recognize that there are certain inherent risks associated with the activity provided by Instructor and I assume full responsibility for personal injury to myself and further release and discharge GPN for injury, loss or damage arising out of my use of or presence upon the facilities of GPN, whether caused by the fault of myself, GPN or other third parties. Such waiver is not intended to waive gross negligence by GPN.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.
Signature
Date Signed

MonthDayYear
Participant Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Resident Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
In case of emergency, please call:
Emergency Contact Name:
Relationship:
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

EXHIBIT B