Waiver & Release from Liability

* indicates a required answer.

WAIVER AND RELEASE FROM LIABILITY

In consideration of the risk of injury while participating in an activity sponsored by Bozer & Associates (the “Activity”), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participate in the Activity, and do hereby release and forever discharge Betty Miller, located at 1228 Wagon Wheel Drive, Sarasota, Florida 34240,  John Bozer, Marjorie Bozer, Bozer and Associates, Debt Free Navigation, Sam Scaggs, Low Horn Consulting, Troy Peterson, Palma Bella Consulting, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns (the “Property Owner & Hosts”), for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity.

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK.  I AM AWARE OF THE RISKS ASSOCIATED WITH TRAVELING TO AND FROM AS WELL AS PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH.  I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL, OR THE CONDITION OF THE ACTIVITY LOCATION(S).  NONETHELESS, I ASSUME ALL REALTED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY, INCLUDING TRAVEL TO, FROM AND DURING THIS ACTIVITY.

I agree to indemnify and hold harmless the aforementioned Property Owner & Hosts against all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf.  If the Property Owner & Hosts incurs any of these types of expenses, I agree to reimburse the Property Owner & Hosts.

I acknowledge that the Property Owner & Hosts and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of the Hosts.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY.  I EXPRESSLY AGREE TO RELEASE AND DISCHARGE THE PROPERTY OWNER & HOSTS AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST THE PROPERTY OWNER & HOSTS FOR PERSONAL INJURY OR PROPERTY DAMAGE.

In the event of an emergency, please contact the following person:

1. *

EMERGENCY CONTACT

2. *

CONTACT RELATIONSHIP

3. *

CONTACT TELEPHONE

I, the undersigned participant, affirm that I am of the age of 18 years or older, and that I am freely signing this agreement.  I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally.  I am aware that this is a release of liability and a contract and that I am signing it of my own free will.

4. *

Participant's Full Name (Last, First)

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Street Address

6. *

City

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State

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ZIP

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I agree to the Waiver and Release from Liability - Selecting Yes on the box below will serve as your electronic signature, certifying that you have read and agree to abide by the Waiver and Release from Liability as written above.  

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