Adopt-a-Street Waiver

Adopt-a-Street Waiver

WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT
Form Description:
This document is a mandatory legal release for participants in the City of Asheville’s Adopt-a-Street Program, outlining the voluntary assumption of risks and the waiver of liability for any potential injury or property damage. By signing, participants agree to hold the City harmless and follow safety guidelines.

Agreement Items
In consideration for the opportunity to participate in City of Asheville Adopt-a-Street Program (“Activity”) I hereby release, waive, discharge and covenant not to sue the City of Asheville, its officials, officers, agents and/or employees (“Releasees”) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or any of the property belonging to me, whether caused by the negligent acts or omissions of the Releasees or otherwise, indirectly or directly connected with my participation in such Activity, or while in, on or upon the premises where the Activity is being conducted.*

I Agree
I am fully aware of the risks involved and hazards connected to this Activity. I agree I have read, comprehend, and agree to follow the Activity's Safety Guidelines. I hereby elect to voluntarily participate in said Activity with full knowledge that said activity may be hazardous to me and my property. I understand that I may cease my participation in this Activity at any time. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained by me, or any loss or damage to property owned by me, as a result of being engaged in such Activity, whether caused by the negligent acts or omissions of Releasees or otherwise.*

I Agree
I further hereby agree to indemnify, hold harmless and defend the Releasees from any loss, liability, damage or costs, including court costs and attorney fees, that they may incur due to my participation in said Activity, whether caused by the negligent acts or omissions of Releasees or otherwise.*

I Agree
It is my express intent that this Agreement shall bind the members of my family, my spouse, my heirs, assigns and personal representatives. I hereby agree that this Agreement shall be construed by the laws of the State of North Carolina.*

I Agree
I give my permission for the use of my name and photographs or digital images of me and/or my children in materials and publications produced and distributed by the Releasees, without compensation. The images may be used in any manner or media without any notification, inspection or compensation. I release the Releasees and those acting pursuant to its authority from liability for any violation of any personal or proprietary right I may have in connection with such recording or use.*

I give permission.I do not give permission.

Emergency Contract Information
Name

First NameLast Name
Relationship to Participant
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Declaration
In signing this release, I acknowledge and represent that I have read the Agreement, understand it and sign voluntarily as my own free act; no oral representations, statements or inducements, apart from the foregoing written agreements, have been made; am fully competent; and I execute this release for full, adequate and complete consideration fully intending to be bound by same. By checking this box and typing my full name below, I am providing my electronic signature.*

I agree
Participant Age*
Email (For Receipt)
example@example.com
Participant Full Legal Name*
(Required for Signature)
Date Signed*

MonthDayYear
If Participant is under 18 years old, Parent/Guardian signed approval is required for Minor participation in Activity. Minor shall be accompanied by Parent/Guardian or Chaperone during the entire Activity.
Parent/Guardian Full Legal Name*
(Required for Signature)
Date Signed*

MonthDayYear
Authorized Chaperone (If Applicable) Full Legal Name
(Required for Signature)
Date Signed

MonthDayYear
Should be Empty:

Adopt-a-Street Waiver

Agreement Items

Emergency Contract Information

Declaration