Waiver, Release and Indemnification Form

 In consideration of the acceptance of my participation in any Rotaract Club of Gladstone Inc. event (hereafter referred to as “the event”) I hereby agree to comply with all the rules, regulations and event instructions of the committee and its directors and organizers.

For myself, my executors, administrators, heirs, next of kin, successors and assigns, I hereby:

waive and release any and all claims that I may have against the Rotaract Club of Gladstone Inc., its event committee, their officers, directors, members, volunteers, employees, agents, sponsors or any one more of them, of their executors, administrators, heirs, next of kin, successors or assigns (“the releases”) including any and all claims for damage caused by the negligence of any of them arising out of my participation in the event and its related activities, together with any costs including legal fees that may be incurred as a result of any such claim whether valid or not, and

indemnify and hold harmless the releases and each of them against any such claim that I or my guests or any one or more of my executors, administrators, heirs, next of kin, successors or assigns may have or assert against any costs including any legal fees with respect thereto.

I hereby acknowledge that I have sole responsibility for my personal possessions and athletic equipment during the event and its related activities.

I hereby acknowledge that participation in the event carries with it potential hazard.  I therefore release the Rotaract Club of Gladstone Inc. and its event committee, their officers, directors, members, volunteers, employees, agents, sponsors or any liability resulting from injury or death during the event and its related activities.

I hereby attest and verify that I am physically fit and have sufficiently trained for this event.  I hereby consent to receive medical treatment, which may be deemed advisable as a result of injury, accident and/or illness during this event.

I hereby state that I have read and understand the Rotaract Club of Gladstone Inc. waiver, release and indemnity form.