Houston Liability Waiver

                            Liability Disclaimer For The Winston-Salem Hurricane Harvey Humanitarian Response team to houston (WSRTH)

 

The collaborative Partners include: The Minister's Conference of Winston Salem & Vicinity, The City of Winston Salem, Baptist Hospital, Love Out Loud (MCBL).

The MCBL  does not provide liability insurance for the protection of individuals, groups, organizations, businesses, spectators, or others who may participate in the WSRTH.

In consideration for your participation in said WSRTH, the individual, group, organization, business, spectator, or other, does hereby release and forever discharge the MCBL, and its officers, board, and employees, jointly and severally from any and all actions, causes of actions, claims and demands for, upon or by reason of any damage, loss or injury, which hereafter may be sustained by participating in the WSRTH.

This release extends and applies to, and also covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, damages, loss and liability and the consequences thereof, as well as those now disclosed and known to exist.  The provisions of any state, federal, local or territorial law or state providing substance that releases shall not extend to claims, demands, injuries, or damages which are known or unsuspected to exist at this time, to the person executing such release, are hereby expressly waived.

I hereby agree on behalf of my heirs, executors, administrators, and assigns, to indemnify the MCBL  and its officers, board and employees, joint and severally from any and all actions, causes of actions, claims and demands for, upon or by reason of any damage, loss or injury, which hereafter may be sustained by participating in the WSRTH.

It is further understood and agreed that said participation in the WSRTH is not to be construed as an admission of any liability and acceptance of assumption of responsibility by the MCBL, its officers, board, and employees, jointly and severally, for all damages and expenses for which the MCBL, its officers, board and employees, become liable as a result of any alleged act of the parade participant.

 

_____________________________________                __________________________________

                                  Name of Organization                             Name of Individual Responsible (Print)
 

____________________________________                _________________                                            
Address                                   Phone
 

_____________________________________                _________________                                            
Signature                                 Date

All participants must complete this Liability Disclaimer to be eligible to participate in the WSRTH trip.