Friends of the Trail

RELEASE AND WAIVER FORM

Community Litter Clean Up Program

 NOTE:  Each volunteer must sign this RELEASE AND WAIVER (below) before starting any work associated with this program.

 I, (Print Name) _______________________________ wish to be a participant in the “Community Litter Clean-Up Program” sponsored by Friends of the Trail, King County, and the Washington State Department of Ecology.

In participating in the volunteer project indicated above, I hereby acknowledge that I understand that there are risks of personal injury, bodily injury (including death)  and/or property damage which may arise from my involvement with this activity.   I understand I am responsible for my own personal safety, belongings, equipment, and automobile while working on this project.  I further acknowledge that I have the physical capacity reasonably necessary to engage in this project.  I hereby waive all claims which I might have against the Friends of the Trial organization, King County, and the Washington State Department of Ecology or any of their officers, agents or employees for any cause of action, or potential cause of action by reason of bodily injury, property damage, expenses, losses or damages which I might suffer arising out of my participation with this activity.

For and in consideration of permission to be a participant in this activity, and with knowledge that the Friends of the Trial organization, King County, and the Washington State Department of Ecology are relying materially thereon in granting such permission, I agree to release, forever discharge, hold harmless and defend the County its officers, officials, employees and agents from any liability or claim of liability which might arise out of my participation in this  activity.

 

Signed_________________________________    Dated________________________

 

Note: If  Participant is a minor, the following portion must be completed.

 PARENT/LEGAL GUARDIAN PERMISSION AND ASSUMPTION OF LIABILITY

 As Parent/Legal Guardian I, (Print Name)_______________________________ hereby grant my permission for the above named minor child to participate in the above referenced activity. I acknowledge, agree and understand that said participation involves risks and inherent dangers that may cause injury and/or death. On behalf of myself and the minor child above I agree release and forever discharge Friends of the Trial organization, King County, and the Washington State Department of Ecology and to assume the liability and obligations referenced above.

 Signed__________________________________    Dated_____________________

 In case of emergency, accident, or illness, I give my permission to be treated by a professional medical person and be admitted to a hospital, if necessary.  I agree to be the party responsible for all medical expenses which are incurred in my behalf.  Furthermore, I give my permission to have photos or videos taken, without recompense, during said volunteer activity to be used for publicity purposes.

________________________________               ________________________

        Signature                                                                   Date           

NAME:    __________________________________________           

ADDRESS: ____________________________________________________________

CITY:   _______________________________  STATE: __________  ZIPCODE:__________

PHONE (With Area Code):  __________________________________

CLEAN U P SITE LOCATION:  ______________________________________

 

I acknowledge receipt of a copy of this waiver.   Initial here: ______________