General Release

• I, __________________, of _______________________________________, do hereby acknowledge that I on the ______ day of __________________, 20___, will participate in a fund raising event sponsored by _______________________________ known as a _________________________________.

• I further acknowledge that I have been advised of the rules for this event, understand them, and will abide by these rules while involved in the event.

• Now, therefore, in consideration for my being permitted to participate in the _______________________ , I voluntarily and knowingly assume the risk for any injuries that I may sustain during the pursuit of my activities or while on any of the properties owned or controlled by the ______________________ . I further, with the intention of binding myself, my spouse, my heirs, legal representatives and assigns, do hereby voluntarily and knowingly remise, release, and forever discharge and hold harmless  _______________ , it’s officers, members and employees from actions, suits, damages, claims or judgements that may result from my personal injury which I sustain while participating in this event.

• I have read and fully understand the provisions of this release and have voluntarily and knowingly execute said release with the express intention of effecting the extinguishment of claims and liability herein designated.  I also understand that it is my responsibility to thoroughly and completely follow instructions given to me by representatives of  ___________________ and my participation may be terminated at any time for breach of instructions.

• The provisions of this release shall prevail until revoked in writing to me, but in no event shall these provisions extend beyond 12:01 a.m. on the _______day of ______________, 20__.

• I also understand and acknowledge that this event will be conducted in whole or in part on privately owned property.  In the event that I or someone for whom I am responsible, causes damage to any property beyond that which is expected in the normal course of an event of this nature, I agree to defend, indemnify, and hold harmless the  ________________, its commissioners, officers, agents, successors, and assigns from any and all claims made as a result of the damage.  I further agree and understand that this indemnification and hold harmless clause shall survive the above referenced termination clause and shall continue in full force and effect until six months after any applicable statutes of limitations shall have expired.

• In testimony whereof, witness my hand on this ______ day of ______________, 20___.

_______________________________                                   ___________________________

                   Releasor                                                                                       Witness

Approved by: ______________________________________________