This is example of simple waiver sample in word doc format to adapt it for your convenience
EVENT NAME / LOCATION EVENT DATE (S)
IN CONSIDERATION of being permitted to compete, officiate,
observe, work for, or participate in any way in the EVENT(S) or being permitted
to enter for any purpose any RESTRICTED AREA (defined as any area requiring
special authorization, credentials, or permission to enter or any area to which
admission by the general public is restricted or prohibited including but not
limited to the competition area and any hot pit area), EACH OF THE UNDERSIGNED,
for himself, his personal representatives, heirs, and next of kin:
1. Acknowledges, agrees, and represents that he/she has or will
immediately upon entering any of such RESTRICTED AREAS, and will continuous
thereafter, inspect the RESTRICTED AREAS which he enters and he further agrees
and warrants that, if at any time, he is in or about RESTRICTED AREAS and he
feels anything to be unsafe, he will immediately advise the officials of such
and will leave the RESTRICTED AREA and/or refuse to participate further in the
EVENT(S). I acknowledge that I may not have the opportunity to inspect any
RESTRICTED AREA prior to the event.
2. HEREBY RELEASES, W AIVES, DISCHARGES AND COVENANTS NOT TO SUE
the promoters, participants, racing associations, sanctioning or administrative
organizations or any affiliated entities thereof, track operators, track
owners, officials, car owners, drivers, pit crews, rescue personnel, any person
in an RESTRICTED AREA, promoters, sponsors, advertisers, owners, lessors, and
lessees of premises used to conduct the EVENT(S), premises and event
inspectors, surveyors, underwriters, brokers, consultants and others who give
recommendations, directions, or instructions or engage in risk evaluation or
loss control activities regarding the premises or EVENT(S) and for each of
them, their directors, officers, agents and employees, all for the purposes
herein referred to as “Releasees”, FROM ALL LIABILITY TO THE UNDERSIGNED, his
personal representatives, assigns, heirs, and next of kin FOR ANY AND ALL LOSS
OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFORE ON ACCOUNT OF INJURY TO THE
PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR
RELATED TO EVENT(S), W HETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR
OTHERW ISE.
3. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the
Releasees and each of them FORM ANY LOSS, LIABILITY, DAMAGE, OR COST INCLUDING
BODILY INJURY OR PROPERTY DAMAGE, they may incur arising out of my presence or
participation in the EVENT(S), W HETHER CAUSED BY THE NEGLIGENCE OR THE
RELEASEES OR OTHERW ISE .
4. HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY
INJURY , DEATH OR PROPERTY DAMAGE arising out of or related to the EVENT(S)
whether caused by the NEGLIGENCE OF RELEASEES or otherwise.
5. HEREBY acknowledges that THE ACTIVITIES OF THE EVENT(S) ARE
VERY DANGEROUS and involve the risk of serious injury and/or death and/or
property damage. Each of THE UNDERSIGNED also expressly acknowledges that
INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS
OR PROCEDURES OF THE RELEASEES.
6. HEREBY agrees that this Release and W aiver of Liability,
Assumption of Risk and Indemnity Agreement extends to all acts of negligence by
the Releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as
broad and inclusive as is permitted by the laws of the Province or State in
which the Event(s) is/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.
I HAVE READ THIS RELEASE AND W AIVER OF LIABILITY, ASSUMPTION OF
RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I
HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND
VOLUNTARILY W ITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME
AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL
LIABILITY TO THE GREATEST EXTENT ALLOW ED BY LAW.
Print name Sign name here
General MS-I
