Responsibility Waiver Form

{{company_name}}

{{company_address}}

Phone: {{phone}} | Email: {{email}} | Web: {{website}}

Responsibility Waiver Form

Responsibility Waiver Form

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

RESPONSIBILITY WAIVER FORM

I, the undersigned, {{participant_name}}, residing at {{participant_address}}, born on {{participant_dob}}, with Identity/Passport Number {{participant_id_number}}, hereby acknowledge and agree to the following terms and conditions in consideration for being permitted to participate in {{activity_name}} (hereinafter referred to as 'the Activity') organised by {{company_name}} (hereinafter referred to as 'the Organiser').

ACKNOWLEDGMENT OF RISKS

I understand and acknowledge that the Activity may involve inherent risks, dangers, and hazards, including but not limited to, physical injury, illness, property damage, and even death. These risks may arise from various factors, including the nature of the Activity, the actions or inactions of other participants or third parties, environmental conditions, and equipment failure. I voluntarily accept and assume all risks, known and unknown, associated with my participation in the Activity.

ASSUMPTION OF RESPONSIBILITY

I understand that my participation in the Activity is entirely voluntary, and I freely choose to participate despite the risks involved. I agree to take full responsibility for my own safety and well-being during the Activity and to follow all instructions, rules, and guidelines provided by the Organiser. I further confirm that I am in good physical and mental health and have no medical conditions that would prevent me from safely participating in the Activity.

RELEASE AND WAIVER OF LIABILITY

In consideration of being permitted to participate in the Activity, I hereby release, waive, discharge, and covenant not to sue {{company_name}}, its directors, officers, employees, agents, representatives, and volunteers (hereinafter collectively referred to as 'the Releasees') from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or any property belonging to me, whether caused by the negligence of the Releasees or otherwise, while participating in the Activity, or while on the premises where the Activity is being conducted.

INDEMNIFICATION

I further agree to indemnify and hold harmless the Releasees from any loss, liability, damage, or costs, including reasonable attorney’s fees, that they may incur due to my participation in the Activity, whether caused by my negligence or otherwise. I understand that this indemnification includes any claims brought by third parties as a result of my actions or inactions during the Activity.

MEDICAL TREATMENT CONSENT

In the event of an emergency, I authorise the Organiser to obtain medical attention for me, if necessary, and I agree to be responsible for all costs associated with such treatment. I understand that the Organiser assumes no financial responsibility for any medical expenses incurred as a result of my participation in the Activity.

SEVERABILITY

I agree that if any portion of this Waiver is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect.

GOVERNING LAW

This Waiver shall be governed by and construed in accordance with the laws of {{applicable_country_code}}.

DECLARATION AND SIGNATURE

I have read this Responsibility Waiver Form, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing this agreement freely and voluntarily, and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

{{signature_line}}

Name of Participant: {{participant_name}}

Date: {{date}}

Witness Name: {{witness_name}}

Witness Signature: {{signature_line}}

Date: {{date}}