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Liability Waiver and Release Form
In consideration of being allowed to participate in the trip sponsored by ServeNow and in consideration of the benefits to be derived therefore, I hereby release ServeNow and its present and former officers, directors, employees, agents and their heirs, administrators, executors, successors, and assigns from all claims and liabilities of any kind, whether known or unknown, which arise from or are connected in any way with my participation or the participation of any member of my family including my spouse or minor child, in the trip.
I recognize that the conditions in some of the places to which I, or my child will travel are not of the same standard as the conditions to which I am accustomed. I realize further that there are certain health risks as well as other risks to personnel and property, and I enter into participation in this trip and agree to the participation of myself or minor child with knowledge of those risks. If for any reason I or my child is unable to complete the planned stay at the project, I assume full responsibility for expenses incurred for myself or my child’s return home.
In the event of an emergency, I hereby authorize a leader of this activity, as an agent for me or my child to consent to: any x-ray examination; medical, dental or surgical diagnosis; treatments; hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state or country where services are rendered, either at a doctor’s office or in a hospital. I expect my family to be contacted as soon as possible.
I certify that I am of a lawful age and competent to sign this release, and have done so voluntarily.
I understand that this document constitutes a full and complete waiver of all possible claims for any act or omission, including claims for negligence regarding injury or property damages, arising out of my participation in the trip.
I understand that this release applies to, covers, and includes unknown, unforeseen, unanticipated, and
unsuspected damages, losses, or liabilities and the consequences thereof; which result from the matters
hereinbefore inferred as well as those now disclosed and known to exist. The provisions of any state, federal, local, territorial law or statute providing in substance that releases shall not extend to claims or damages which are unknown or unsuspected to exist at the time are hereby expressly waivered by me.
Name of Participant
Date of Trip
Name of the signer of this document (if participant is under 18 years of age)
Relation to Participant
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