WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
PHYSICAL ACTIVITY, OUTDOOR EXCURSION AND FIELD TRIP
ACKNOWLEDGEMENT:
As a participant in recovery housing and therapeutic activities with Elite Recovery dba Elite Advantage and/or Elite Empower, I hereby assume all of the risks of participating in any physical activity, outdoor excursion, field trip, recreational game/activity or any other activity that includes physical exertion and risk of harm or injury, heretofore referred to as “ACTIVITY” including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of the ACTIVITY in which I may participate and that it will govern my actions and responsibilities at said ACTIVITY. In consideration of my application and permitting me to participate in this ACTIVITY, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
WAIVE, RELEASE AND DISCHARGE:
I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this ACTIVITY. This waiver applies to THE FOLLOWING ENTITIES OR PERSONS: OMNIA BEHAVIORAL HEALTH, HOROWITZ HEALTH, ELITE RECOVERY, RECOVERY HOMES OF MINNESOTA, and/or their staff, agents, representatives or volunteers.
INDEMNIFY, HOLD HARMLESS AND PROMISE NOT TO SUE
I indemnify, hold harmless and promise not to sue the entities or persons identified in the previous paragraph and all liabilities or claims made as a result of participation in this ACTIVITY, whether caused by negligence or otherwise. I acknowledge that this ACTIVITY may carry with it the potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, and lack of hydration.
ACKNOWLEDGEMENT OF UNDERSTANDING
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL.
I HAVE READ AND UNDERSTOOD THE ABOVE TERMS:
