Participant Liability Form
The parties to this Release are you, the Participant, and BRIDGE4YOUTH and Korean Central Presbyterian Church (“KCPC”).

The Participant has chosen to participate in the BRIDGE FALL FEST 2016 on Saturday, October 29th.

Assumption of Risk. Participant expressly understands and agrees that participation in Activity may present risks to Participant both serious and minor, including but not limited to head or other injuries, loss of sight, broken bones, brain damage, paralysis and death.

Participant further recognizes, understands and agrees that BRIDGE4YOUTH and KCPC assumes no responsibility for any liability, damage or injury that may be caused by Participant’s negligence or willful acts committed prior to, during or after participation in the Activity, or for any liability, damage or injury caused by the intentional or negligent acts or omissions of any other participant in the Activity, or caused by any other person.

Indemnification and Hold Harmless. Participant specifically understands that she/he is personally responsible, agrees to indemnify, defend and holds harmless BRIDGE4YOUTH/ KCPC, their officers, elders, deacons, faculty, agents, volunteers, students, employees and representatives from any action, claim, or demand that his/her heirs, or legal representatives, have or may have for any and all personal injuries he/she may suffer or sustain, regardless of cause or fault as a result of his/her voluntary decision to participate in the Activity or related activities, on or off BRIDGE4YOUTH/ KCPC’s real property located at 15451 Lee Highway, Centreville, VA 20121 including reasonable attorneys’ fees and/or any other associated costs, caused by any act or omission of Participant resulting from direct or indirect participation in the Activity.

Release of Claims. In consideration of being allowed to participate in the Activity, Participant, his/her heirs, executors, administrators, employers, agents, representatives, insurers, and attorneys, hereby release and discharge BRIDGE4YOUTH/ KCPC, their officers, elders, deacons, faculty, agents, employees, volunteers, students, and representatives (hereafter “Released Parties”) from any and all claims which may arise from any cause whatsoever, including any negligent act or omission by the Released Parties. Participant further releases and discharges the Released Parties from liability for any accident, illness, injury, loss or damage to personal property, or any other consequences arising or resulting directly or indirectly from Participant’s participation in the Activity. The Participant acknowledges and agrees that the Released Parties assume no responsibility for any liability, damage, or injury that may be caused by Participant’s negligent or intentional acts or omissions committed prior to, during, or after participation in the Activity, or for any liability, damage, or injury cause by the intentional or negligent acts or omissions of any other participant in the Activity, or caused by any other person.

Termination of Participation. Participant understands and agrees to abide by all policies, rules, and regulation. Participant shall not engage in inappropriate conduct including the use of physical or verbal violence. Participant understands that BRIDGE4YOUTH/ KCPC or their representative may terminate Participant’s participation in the Activity at any time. Reasons for termination may include, but are not limited to: inappropriate conduct or other behavior by Participant deemed detrimental to the best interests of the Activity; emergencies; or health or safety considerations.

Physical Condition and Insurance. Participant attests that she/he is physically capable of participating and has no known health restrictions that might jeopardize her/his safety or health or the safety or health of others during their participation in the Activity.

Severability. It is understood and agreed that, if any provision of this release or the application thereof is held invalid, the invalidity shall not affect other provisions or applications of this release which can be given effect without the invalid provisions or applications. To this end, the provisions of this release are declared severable.

Governing Law and Venue. This release shall be construed in accordance with, and governed by, the laws of the Commonwealth of Virginia. The venue for any action arising out of this Agreement shall be the County of Fairfax, State of Virginia. The parties agree to submit to jurisdiction in Fairfax County, Virginia.

Construction and Scope of Agreement. The language of all parts of this release shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any party. This release is the only, sole, entire, and complete agreement of the parties relating in any way to the subject matter hereof. No statements, promises, or representations have been made by any party to any other, or relied upon, and no consideration has been offered or promised, other than as may be expressly provided herein. This release supersedes any earlier written or oral understanding or agreements between the parties.

Participant acknowledges that she/he including his/her legal guardian has read this release and that she/he fully understands its meaning and effect.

Please confirm that you have read the release of liability form and electronically sign your name and date at the end.

Team Name *
Your answer
I, the Participant, acknowledge that I have read this release and fully understand its meaning and effect. *
Participant Signature *
Your answer
Phone Number *
Your answer
Email *
Your answer
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