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Sample Release and Emergency Contact Form

THIS IS A SAMPLE OF THE RELEASE YOU WILL HAVE TO SIGN TO PARTICIPATE IN EACH EVENT:

Release and Emergency Contact Info

(Warning: Hiking and Rock Scrambling are Hazardous!)

Event: .... NAME OF EVENT GOES HERE .... Date:


(A non-commercial, non-professional, non-insured, free event by and for like-minded individuals.)

Participation in this event is dangerous. It can result in serious injury, medical emergency, even death. By printing and/or signing your name below (or doing so electronically when you RSVP to an event), you agree to participate completely at your own risk and to take full responsibility for your own safety and well being. You will hold neither the leader(s), nor organizer(s), nor other participant(s) responsible for any accident and/or mishap, regardless of how serious. This release applies even if such accident(s) and/or mishap(s) is/are the result of some bad decision, poor judgment and/or terribly negligent action by the leader(s), organizer(s) and/or other participant(s). You agree that this release also binds your heirs, assigns and estate.

In addition, should (despite this release) you or your heirs, assigns and/or estate bring action against any organizer(s), leader(s), and/or participant(s) of this group as a result of this activity, and should such action fail to prevail, you (and/or your heirs, assigns, and/or estate) will reimburse the organizer(s), leader(s) and/or participant(s) for any expenses, legal or otherwise, they may incur in defending against such action.

If you bring a guest or guests, you represent that they too have read and agree to our liability release and that you, not the organizers or leaders, are responsible for those guests. Should one or more of your guests bring a lawsuit against any organizer or leader that arises from this activity, you agree to hold harmless and reimburse all costs that the organizers or leaders might incur as a result of such lawsuit.

Print Full Name................Sign Name .............................Emergency Contact Phone

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Table of Contents

Page title Most recent update Last edited by
DEC Land Use Guidelines April 16, 2013 12:06 PM Rob
Standard of Care and Your Responsibility October 1, 2011 9:54 PM Rob
Sample Release and Emergency Contact Form July 7, 2014 6:12 PM Rob
About New York Hiking and Outdoor Adventurers October 9, 2011 11:01 PM Rob

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