Scroll to see more shifts & complete your submission at the bottom of the page.Click here to scroll down.
Disclaimer
Liability Form
BOULDER CREST FOUNDATION
RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT
IN CONSIDERATION for being permitted to participate in activities (the “Activities”) on or about the Boulder Crest Foundation facilities owned and operated by Boulder Crest Foundation (the “Foundation”), I, for myself, the Minor (as defined below, if applicable) and for my and the Minor’s personal representatives, assigns, heirs and next of kin, do hereby RELEASE, WAIVE, FOREVER DISCHARGE, COVENANT NOT TO SUE, AGREE TO INDEMNIFY, AND SAVE AND HOLD HARMLESS, the Foundation, its partners, officers, directors, agents, affiliates, employees, volunteers and their respective successors and assigns (collectively, the “Released Parties”) from any and all claims, demands, losses, actions, liabilities, and causes of action of any sort, known or unknown, foreseen or unforeseen, including, but not limited to, death, bodily injury, or property damage that I (or the Minor, if applicable) might sustain or suffer resulting from, or in any manner connected with, my (or the Minor’s, if applicable) participation in the Activities, including, without limitation, those caused by the negligence, wrongful acts, or omissions of the Foundation or the Released Parties.
1. I ACKNOWLEDGE that the Activities may include, among other things, lodging, swimming, canoeing, kayaking, tubing, fishing, hiking, biking, archery, and being in close proximity to horses and other animals and wildlife. I acknowledge, agree, and represent that I understand the nature of the Activities and that I am qualified, in good health, am in proper physical condition and have sufficiently prepared or trained for participation in the Activities, and have not been advised to refrain from participating in the Activities by any health professional. I certify that there are no health-related reasons or problems which preclude my participation in the Activities. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activities.
2. I FULLY UNDERSTAND THAT: (a) THE ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“RISKS”); (b) the Risks may be caused by my own actions or inaction, the actions or inaction of the Minor, or the actions or inaction of others participating in the Activities, the condition in which the Activities take place, or THE NEGLIGENCE OF THE RELEASED PARTIES NAMED ABOVE; (c) the Risks may be caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, and lack of hydration; and (d) to participate in the Activities, I (and the Minor, if applicable) must be covered by private medical insurance and I (and the Minor, if applicable) agree to recover all damages first from such insurance carrier for any and all injuries that occur in connection with the Activities. I acknowledge that there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time, and I FULLY ACCEPT AND ASSUME ALL RISKS AND OTHER SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES that I (and the Minor, if applicable) incur as a result of my participation and/or that of the Minor in the Activities.
3. I hereby consent to receive medical treatment (for myself, or on behalf of the Minor, if applicable) which may be deemed advisable by Foundation staff in the event of injury, accident, and/or illness during the Activities.
4. [APPLIES ONLY IF PARTICIPANT IS UNDER AGE 18] AS THE PARENT AND/OR LEGAL GUARDIAN OF THE PARTICIPANT LISTED BELOW (THE “MINOR”), I UNDERSTAND THE NATURE OF THE ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITIES. I FURTHER AGREE AND WARRANT THAT IF AT ANY TIME I BELIEVE CONDITIONS TO BE UNSAFE, I WILL IMMEDIATELY DISCONTINUE THE MINOR’S PARTICIPATION IN THE ACTIVITIES.
I HAVE READ THIS DOCUMENT CAREFULLY, FULLY UNDERSTAND ITS CONTENTS, INCLUDING THE INDEMNITY CONTAINED HEREIN, AND INTEND THE RELEASE TO BE A COMPLETE AND UNCONDITIONAL RELEASE AND WAIVER OF LIABILITY TO THE FULLEST EXTENT PERMITTED BY LAW. IF ANY PROVISION(S) OF THIS AGREEMENT IS HELD TO BE INVALID OR UNENFORCEABLE, THE REMAINING PROVISIONS SHALL NOT BE AFFECTED AND SHALL CONTINUE IN FULL FORCE AND EFFECT. THIS AGREEMENT SHALL BE GOVERNED IN ALL RESPECTS BY THE LAWS OF THE COMMONWEALTH OF VIRGINIA WITHOUT REGARD TO ITS LAWS OR REGULATIONS RELATING TO CHOICE OF LAWS.
In witness whereof, I have voluntarily signed this Release and Waiver of Liability and Indemnity Agreement on the date set forth below:
5054012-2 036589.00001
----
Boulder Crest Photo Release
I hereby grant permission to Boulder Crest Foundation and its affiliates, agents or employees, to use photographs taken of me on the date and at the location listed below for use in organization publications, both printed and electronic.
I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photograph.
I hereby agree to release, defend, and hold harmless Boulder Crest Foundation and its agents or employees, including any firm publishing and/or distributing the finished product in whole or in part, whether on paper or via electronic media, from and against any claims, damages, or liability arising from or related to the use of the photographs, including but not limited to any misuses, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution. It is the discretion of Boulder Crest Foundation to decide whether to use the image.
I am 18 years of age and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to singing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.
Liability Form
BOULDER CREST FOUNDATION
RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT
IN CONSIDERATION for being permitted to participate in activities (the “Activities”) on or about the Boulder Crest Foundation facilities owned and operated by Boulder Crest Foundation (the “Foundation”), I, for myself, the Minor (as defined below, if applicable) and for my and the Minor’s personal representatives, assigns, heirs and next of kin, do hereby RELEASE, WAIVE, FOREVER DISCHARGE, COVENANT NOT TO SUE, AGREE TO INDEMNIFY, AND SAVE AND HOLD HARMLESS, the Foundation, its partners, officers, directors, agents, affiliates, employees, volunteers and their respective successors and assigns (collectively, the “Released Parties”) from any and all claims, demands, losses, actions, liabilities, and causes of action of any sort, known or unknown, foreseen or unforeseen, including, but not limited to, death, bodily injury, or property damage that I (or the Minor, if applicable) might sustain or suffer resulting from, or in any manner connected with, my (or the Minor’s, if applicable) participation in the Activities, including, without limitation, those caused by the negligence, wrongful acts, or omissions of the Foundation or the Released Parties.
1. I ACKNOWLEDGE that the Activities may include, among other things, lodging, swimming, canoeing, kayaking, tubing, fishing, hiking, biking, archery, and being in close proximity to horses and other animals and wildlife. I acknowledge, agree, and represent that I understand the nature of the Activities and that I am qualified, in good health, am in proper physical condition and have sufficiently prepared or trained for participation in the Activities, and have not been advised to refrain from participating in the Activities by any health professional. I certify that there are no health-related reasons or problems which preclude my participation in the Activities. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activities.
2. I FULLY UNDERSTAND THAT: (a) THE ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“RISKS”); (b) the Risks may be caused by my own actions or inaction, the actions or inaction of the Minor, or the actions or inaction of others participating in the Activities, the condition in which the Activities take place, or THE NEGLIGENCE OF THE RELEASED PARTIES NAMED ABOVE; (c) the Risks may be caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, and lack of hydration; and (d) to participate in the Activities, I (and the Minor, if applicable) must be covered by private medical insurance and I (and the Minor, if applicable) agree to recover all damages first from such insurance carrier for any and all injuries that occur in connection with the Activities. I acknowledge that there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time, and I FULLY ACCEPT AND ASSUME ALL RISKS AND OTHER SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES that I (and the Minor, if applicable) incur as a result of my participation and/or that of the Minor in the Activities.
3. I hereby consent to receive medical treatment (for myself, or on behalf of the Minor, if applicable) which may be deemed advisable by Foundation staff in the event of injury, accident, and/or illness during the Activities.
4. [APPLIES ONLY IF PARTICIPANT IS UNDER AGE 18] AS THE PARENT AND/OR LEGAL GUARDIAN OF THE PARTICIPANT LISTED BELOW (THE “MINOR”), I UNDERSTAND THE NATURE OF THE ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITIES. I FURTHER AGREE AND WARRANT THAT IF AT ANY TIME I BELIEVE CONDITIONS TO BE UNSAFE, I WILL IMMEDIATELY DISCONTINUE THE MINOR’S PARTICIPATION IN THE ACTIVITIES.
I HAVE READ THIS DOCUMENT CAREFULLY, FULLY UNDERSTAND ITS CONTENTS, INCLUDING THE INDEMNITY CONTAINED HEREIN, AND INTEND THE RELEASE TO BE A COMPLETE AND UNCONDITIONAL RELEASE AND WAIVER OF LIABILITY TO THE FULLEST EXTENT PERMITTED BY LAW. IF ANY PROVISION(S) OF THIS AGREEMENT IS HELD TO BE INVALID OR UNENFORCEABLE, THE REMAINING PROVISIONS SHALL NOT BE AFFECTED AND SHALL CONTINUE IN FULL FORCE AND EFFECT. THIS AGREEMENT SHALL BE GOVERNED IN ALL RESPECTS BY THE LAWS OF THE COMMONWEALTH OF VIRGINIA WITHOUT REGARD TO ITS LAWS OR REGULATIONS RELATING TO CHOICE OF LAWS.
In witness whereof, I have voluntarily signed this Release and Waiver of Liability and Indemnity Agreement on the date set forth below:
5054012-2 036589.00001
----
Boulder Crest Photo Release
I hereby grant permission to Boulder Crest Foundation and its affiliates, agents or employees, to use photographs taken of me on the date and at the location listed below for use in organization publications, both printed and electronic.
I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photograph.
I hereby agree to release, defend, and hold harmless Boulder Crest Foundation and its agents or employees, including any firm publishing and/or distributing the finished product in whole or in part, whether on paper or via electronic media, from and against any claims, damages, or liability arising from or related to the use of the photographs, including but not limited to any misuses, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution. It is the discretion of Boulder Crest Foundation to decide whether to use the image.
I am 18 years of age and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to singing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.
Check here to show you accept the terms stated above for yourself or for a minor Volunteer for which you are the parental guardian.