SML Event & Liability Form Date NameFirstLast Email Event SML ROTARY EVENT & LIABILITY WAIVERI, _______________________, wish to participate in the _________________________ event, which is sponsored by the Rotary Club of Smith Mountain Lake. I understand that my participation in this event is voluntary and at my own risk. I understand that such participation may result in an accident, injury, illness or death, and I hereby acknowledge such risk and assume full responsibility for such risk. In exchange for being permitted to participate in this event, I hereby agree to the following: 1. I hereby release, waive, discharge and covenant not to sue the Rotary Club of Smith Mountain Lake and the Smith Mountain Lake Rotary Foundation, their members, foundation Trustees, directors, officers, volunteers and agents, from all liability to me, my successors, assigns, heirs, and next of kin for any loss or damage, and any claim or demand on account of any accident, injury, illness or death resulting from my participation in or attendance at this event, whether the act or omission giving rise to such claim is known or unknown at this time or caused by the negligence of such released party. 2. I hereby agree to indemnify and hold harmless the Rotary Club of Smith Mountain Lake and the Smith Mountain Lake Rotary Foundation, their members, foundation Trustees, directors, officers, volunteers and agents, from any loss, liability, damages or costs they may incur as a result of any accident, injury, illness or death resulting from my participation in or attendance at the event, whether the act or omission giving rise to such claim is known or unknown at this time or caused by the negligence of such party. 3. Notwithstanding the provisions herein, nothing in this Waiver and Release of Liability releases, limits or prevents me from making any claim against the Rotary Club of Smith Mountain Lake and the Smith Mountain Lake Rotary Foundation, their members, foundation Trustees, directors, officers and agents, that is caused by the gross negligence, willful misconduct or intentional act of such party. If any provision of this Waiver and Release of Liability is deemed invalid, I hereby agree that the remaining provisions will remain in full force and effect. By my signature below, I acknowledge that I have read and understand the terms of this Waiver and Release of Liability, and I voluntarily agree to comply with its terms. I also acknowledge that I have the capacity and authority to sign this Waiver and Release of Liability. ___________________________________________________ __________________________ Signature Date ___________________________________________________ Printed NameSubmitReset
