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The Big BackIn (BBI) release and waiver of liability, assumption of risk, and indemnity and
parental consent agreement (agreement). In consideration of being permitted to participate in
any way in the Big BackIn event & it's sponsors, I, for myself, my personal representatives, assigns,
heirs, and next of kin:
1. Acknowledge, agree and represent that I understand the nature of BBI activities and that I am qualified,
in good health and in proper physical condition to participate in such activity. I further acknowledge that
the activity will be conducted over public roads and facilities open to the public during the activity and
upon which the hazards of traveling are to be expected. I further agree and warrant that if at any time I
believe conditions to be unsafe I will immediately discontinue further participation in the activity.
2. Fully understand that: a) BBI activities involve risks and dangers of serious bodily injury, including
permanent disability, paralysis and death (risks); b) these risks and dangers may be caused by my own
actions, or inactions of others participating in the activity, the condition in which the activity takes place,
or the negligence of the "releasees" named below; there may be other risks and social and economic losses
either not known to me or not readily foreseeable at this time; and I fully accept and assume all
such risks and responsibility for losses, costs and damages I incur as a result of my participation or that
of the minor in the activity.
3. Hereby release, discharge, covenant not to sue the BBI, their respective administrators, directors, agents,
officers, members, volunteers, other participants, advertisers, and if applicable, owners and lessors of
premises on which the activity takes place (each considered one of the "releasees" herein) from all
liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole
or in part by the negligence of the "releasees" or otherwise, including negligent rescue operation;
and I further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity
agreement I, or anyone on my behalf, makes a claim against any of the releasees, I will indemnify, save
and hold harmless each of the releasees from any litigation expenses, attorney fees, loss, liability, damage,
or cost which any may incur as the result of such claim.
I have read the agreement, fully understand its terms, understand that I have given up substantial rights
by signing it and have signed it freely and without any inducement or assurance of any nature and intend
it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree
that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in
full force and effect.
Date:_____________________ Signature________________________________________
18 years or older ___yes ___no
Minor Release
And I, the minor's parent and/or legal guardian, understand the nature of the activity and to the minor's
experience and capabilites and believe the minor to be qualified, to participate in such activity. I have
read the foregoing Waiver, Disclaimer and Release, and understand its application in full to the minor.
Print Parent/Legal Guardian Name______________________________________________
Address_________________________________________________________________
Phone Number(s)
__________________________________________
Parent/Legal Guardian Signature________________________________________________
Minor's Signature___________________________________________________________ |
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