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Individuals Release Inherently Dangerous Activity

Release executed on _____ (date), by _____ (name), of _______ (address), here referred to as releasor.

In consideration of being permitted to participate in ________ (insert nature of dangerous activity, such as: racing events or skydiving or as the case may be) conducted by _____ (name), releasor, for ______ (himself or herself), (if applicable, here add: _____ (his or her) spouse,) legal representatives, heirs and assigns, hereby releases, waives and discharges _______ (name), releasee, its officers and members, _______ (insert here other parties such as: promoters, sponsors, advertisers, owners and lessees of the premises) and each of them, their officers and employees, here referred to as releasees, from all liability to the releasor, (if applicable, here add: _____ (his or her) spouse,) legal representatives, heirs and assigns, for any and all loss or damage, and any claim or damages resulting therefrom, on account of injury to releasors person or property, even injury resulting in death of the releasor, whether caused by the negligence of releasees or otherwise while the releasor is _____ (competing, working or for any purpose participating in _______ (name of activity).

Releasor agrees to indemnify the releasees and each of them from any loss, liability, damage or cost they may incur due to the presence of releasor in or upon _____ (describe area in which activity will occur), whether caused by the negligence of the releasees or otherwise.

Releasor hereby assumes full responsibility for the risk of bodily injury, death or property damage due to the negligence of releasees or otherwise while in or upon ______(describe area in which dangerous activity will occur) and while competing, officiating in, working or for any purpose participating in ______ (name of activity).

Releasor expressly agrees that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of ________, ______ (cite appropriate statute,) and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

In witness whereof, releasor has executed this release at _____ (designate place of execution) the day and year first above written.

Dated: ______________.

_____________________________

Signature

(Acknowledgement)