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RELEASE AND WAIVER OF LIABILITY, ASSUMPTION, OR RISK AND INDEMNITY AGEEMENT
MADAWASKA FOUR CORNERS PARK ASSOCIATION, MADAWASKA,MAINE
IN CONSIDERATION of being permitted to compete, officiate ,observe, work for ,or participate in any way in any Madawaska Four Corners Park Association
,events or activities (EVENT(S) or being permitted to enter for any purpose and 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), I for myself, my personal representatives,
heirs, and next of kin:
1....Acknowledge, agree and represent that I have or will immediately upon entering any of such RESTRICTED AREA(S) and continuously thereafter, will
inspect the RESTRICTED AREA(S) which I enter, and I further agree and warrant that , if at any time, I am in or about RESTRICTED AREA(S) and I feel
anything to be unsafe, I will immediately advise the officials of such and if necessary will leave the RESTRICTED AREA(S) and /or refuse to participate further
in the EVENT(S)
2......HEREBY RELEASE ,WAVE,DISCHARGE, AND COVENANT NOT TO SUE ,the promoters, participants, any subdivision thereof officials, motorcycle owner,
riders, pit crew, rescue personnel, underwriters, consultants and others who give recommendations, directions, or instructions or engage in risk evaluation or loss
of control activities, regarding the premises or EVENT(S) and each of them, their directors, officers, agents, employees, for the purposes herein referred to as
"Releasees," FROM ALL LIABILITY TO THE UNDERSIGNED, his/her personal representatives, assigns, heirs, and next of kin FOUR ANY AND ALL LOSS OR
DAMAGE,AND ANY CLAIM OR DEMANDS THEREFORE ON ACCOUNT OF INJURY TO THE JPERSON OR PROPERTY OR RESULTING IN DEATH OF THE
UNDERSIGNED ARISING OUT OF OR RELATED TO THE EVENT(S), WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
3......HEREBY AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasees and their insurance carrier, and each of them FROM ANY
LOSS,LIABILITY, DAMAGE,OR COST they may incur arising out of or related to the EVENT(S) WHETHER CAUSED BY THE NEGLIGENCE OF THE
RELEASEES OR OTHERWISE.
4....HERBY ASSUME FULL RESPONSIBLITY FOR ANY RISK OF BODLY INJURY,DEATH OR PROPERTY DAMAGE arising out of , or related to the EVENT(S)
whether caused by NEGLIGENCE OF RELEASEES or otherwise.
5.....HERBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE POTENTIALLY VERY DANGEROUS and involve the risk of serious injury and/or death
and /or property damage. I also expressly acknowledge that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLGENT RECUE
OPERATIONS OR PROCEDURES OF RELEASEES.
6.....IF ,DESPITE, THIS RELEASE, I OR ANYONE ON MY BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES,NAMED ABOVE, I AGREE TO
INDEMNIFY AND SAVE, AND HOLD HARMLESS THE RELEASEES AND THE INSURANCE CARRIER, AND EACH OF THEM FROM ANY LITIGATION
EXPENSES,ATTORNEYS'FEES,LOSS ,LIABILITY,DAMAGE, OR COSTS THEY MAY INCUR DUE TO THE CLAIM MADE AGAINST ANY OF THE RELEASEES
NAMED ABOVE, WHETHER THE CLAIM IS BASED ON THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
7....HEREBY agree that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence by the
Releasees, INCLUDING NEGLIGENT RESCUE OPERTATIONS, and is intended to be as broad and inclusive as is permitted by the law 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 WAIVER 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 WITHOUT
INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF
ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW
PRINT NAME HERE SIGN NAME HERE
_________________________________ ______________________________________ State of________________________
_________________________________ _______________________________________ County of:_______________________________
Subscribed and sworn to (or affirmed) before me
Important: Sign with Notary, Do not pre-sign
this _____day of__________ in the year________
Failure to provide a completed Waiver and Release of Liability Form
to the Madawaska Four Corners Park Association will make you Signature of Notary Public
ineligible to participate in the event.
My Commission Expires_____________________