WAIVER AND ASSUMPTION OF RISK

The undersigned, ___________________________________ (Student/Participant), voluntarily makes and grants this Waiver and Assumption of Risk in favor of ____________________________________ (Instructor/Event Coordinator) as partial consideration (in addition to monies paid to Instructor/Event Coordinator for the opportunity to use the facilities, equipment, materials and/or other assets of Instructor/Event Coordinator; and/or to receive assistance, training, guidance, tutelage and/or instruction from the personnel of Instructor/Event Coordinator; and/or to engage in the activities, events, sports, festivities and/or gatherings sponsored by Instructor/Event Coordinator; I do hereby waive and release any and all claims whether in contract or of personal injury, bodily injury, property damage, damages, losses and/or death that may arise from my aforementioned use or receipt, as I understand and recognize that there are certain risks, dangers and perils connected with such use and/or receipt, which I hereby acknowledge have been fully explained to me and which I fully understand, and which I nevertheless accept, assume and undertake after inquiry and investigation of extent, duration, and completeness wholly satisfactory and acceptable to me. I further agree to use my best judgment in undertaking these activities, use and/or receipt and to faithfully adhere to all safety instructions and recommendations, whether oral or written. I hereby certify that I am a competent adult assuming these risks of my own free will, being under no compulsion or duress. This Waiver and Assumption of Risk is effective from ____/____/____ to ____/____/____, inclusive, and may not be revoked, altered, amended, rescinded or voided without the express prior written consent of _____________________________________ (Instructor/Event Coordinator).

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Print Name Date

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Student’s/Participant's Signature Age

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Address      City, State, Zip Code

Here is an example of a waiver that includes an asumption of risk and can be used for lessons or small events.  Feel free to use this to create your own waiver.  If you would like to have a Microsoft Word version of this contract just click on the link below.

Participation Guidelines and Waiver of Liability and Photo.doc