Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement
NOTICE:
● This is a legal instrument, has legal significance and affects your legal rights. Read and understand it before you sign.
● You are under no obligation to take this training class. However, if you choose to take this class, in return you must complete and sign this form.In consideration of permitting me to participate in recreational and /or technical rescue training and related training (collectively "Training") conducted by, sponsored by, or held on the property of, the Charlottesville- Albemarle Rescue Squad, Inc., (CARS), I, for myself, my personal representatives, heirs and assigns:
HEREBY ACKNOWLEDGE:
● that the activities involved in the Training are of a hazardous nature and contain inherent risks of serious injury and/or death and/or property damage and may be conducted at sites that are remote, either by time or distance or both, from medical facilities. The undersigned also expressly acknowledges that injuries received may be compounded or increased by negligent rescue operations or procedures of the Releasees and/or others.
● that it is entirely my responsibility to determine that I have and wear proper protective equipment, have proper physical and mental health, appropriate training and/or prior experience for each Training class. I alone am responsible for the suitability and condition of my personal protective equipment.
● that no insurance coverage is provided me by CARS or any other entity or person conducting the Training. It is my responsibility to arrange such coverage through my personal insurance or my agency prior to participating in the Training.
HEREBY REPRESENT that I have educated myself as to the Training requirements, and I a) have no physical or mental condition, nor b) am I taking any prescription or non-prescription medication that would preclude my participation in the Training.
HEREBY AGREE:
● for the duration of the Training to be free from the influence of alcohol and all drugs (prescription or non-prescription) that affect mental awareness or physical coordination or capability;
● to follow any rules provided me by members or officers of CARS and/or the Training instructors;
● that the Training instructors and/or officers of CARS may require me to leave the training program if they, in their sole discretion, believe that my actions, attitude or conduct are detracting from the safety or participation of themselves or other participants or compromisingother site users; and,
● that no Training instructor or officer of CARS is authorized to modify this instrument in any way.
THEREFORE, I HEREBY RELEASE, WAIVE, DISCHARGE (AND COVENANT NOT TO SUE) the Charlottesville – Albemarle Rescue Squad, Inc., and all of its officers, instructors, agents and members (all collectively the "Releasees") FROM ALL LIABILITY TO ME, my personal representatives, heirs, and assigns FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFOR ON ACCOUNT OF INJURY TO MY PERSON OR PROPERTY OR RESULTING IN MY DEATH, NOW AND FOREVER, ARISING OUT OF OR RELATED TO PARTICIPATION IN THIS TRAINING, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I HEREBY ASSUME FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, now and forever, arising out of or related to participation in this training class, whether foreseen or unforeseen, known or unknown, and whether caused by the negligence of the Releasees or otherwise, I HEREBY SEPARATELY agree to INDEMNIFY and SAVE and HOLD HARMLESS the Releasees from any loss, liability, damage or cost they may incur, now and forever, arising out of or related to participation in the Training, whether caused by the negligence of the Releasees or otherwise, expressly including any claim by unforeseen third parties that techniques taught in this program caused or aggravated any property damage or personal injury because I applied the same in Training or an emergency response.
I HEREBY acknowledge that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES or others and agree that this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence by Releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as permitted by the laws of the State of Virginia or the state in which the activities are conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.