ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
Name of the Activity or Event: __________________________Date of Activity or Event: __________________
Check One: Scientific Field Trip Child Care or Youth Activities Student Volunteering
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS
ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence
or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or
property owned, maintained, or controlled by them, or because of their possible liability withou t fault.
I certify that I am ph ysically fit, have sufficiently prepared or trained for participation in the activity or event, and
have not been advised to not partic i pate by a quali fi ed medical professional. I certify that there are no health-related
reasons or problems which preclude my participation in th is activity or event.
I acknowledge that this Accident Waiver and Release of Liability Fo rm will be used by the event holders, sponsors,
and organizers of the activity or event in which I may participate, and that it will govern my actions and
responsibilities at said activity or event.
In consideration of my ap plication and permitting me to participate in th is event, I hereby take action for myself, my
executors, administrators, heirs, next of kin, s uccessors , and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability
arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury,
property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to
and from this event, THE FOLLOWING ENTITIES OR PERSONS: The International Ass ociation of Landscape
Ecology – US Regional Association (US-IALE) and/or their directors, officers, employees, volunteers,
representatives, and agents, the activity or event holders, activity or event sponsors, activity or even t volunteers;
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this
paragr aph from any and all liabilities or clai ms made as a result of participation in this activ ity or even t, whether
caused by the negligence of release or otherwise.
I acknowledge that the US-IALE and their directors, officers, volunteer s, r e prese nt at i ves, and agents are NOT
responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific event or
activity on behalf of the US-IALE
I acknowledge that th is activity or even t may involve a test of a person’s physical and mental limits and may carry
with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those
caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of
other people inclu ding, but not limited to, participants, volunteers, spectators, coaches, event officials, and event
monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to participants, but
are also present for volunteers.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident,
and/or illness during this activity or event.
I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film
likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns.
The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the
maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM
AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN
_____________ _________ __________ _______ _____________ _________ _________ __________
Print Participant’s Name Age Signature (if under 18 years old, Date
Parent or guardian must also sign)