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Whilst others imitate we continue to innovate. Why settle for a copy when you can have the original?
Tel: 941 697 0324 | Fax: 941 697 1249
[email protected] | www.galaxymultirides.com
In consideration of the services of ______________________, its employees and agents
(collectively,“_______________________”), I agree to release, hold harmless and indemnify __________________,
on behalf of myself and my family members, partners, heirs and assigns as follows:
1. I acknowledge that riding a _______________________________________ (name of the ride) entails risks that
could result in physical or emotional injury, paralysis, death, injury or damage to me, to property, or to third
parties. I understand that the risks cannot be eliminated without jeopardizing the essential qualities of the
activity. The risks could result in musculoskeletal injuries, including head, neck, and back injuries.
2. I accept and assume all the risks of participating in this activity. My participation in this activity is purely voluntary,
and I elect to participate in spite of the risks.
3. I release and agree to indemnify and hold harmless ______________ from any claims
that are in any way
connected with my participation in this activity or my use of
______________
equipment or facilities,
including
claims that _________________ was negligent
. However, I do not release any claims related to intentional or
reckless acts by
_______________
.
4. I have adequate insurance to cover any injury or damage I may cause or suffer while participating or I agree to
bear the costs of any injury or damage.
5. I agree that, if I bring a lawsuit against __________________, I will do so solely in the State of ______________
and the substansive law of the State of _____________ will apply in that lawsuit without regard to the conflict
of law rules. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining
portions shall remain in full force and effect.
By signing this document, I acknowledge that if that anyone is hurt or property is damaged during my
participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit
against
____________________
on the basis of any claim from which I have released them. I have had sufficient
opportunity to read this agreement. I have read and understood it, and agree to be bound by its terms.
Signature of Participant: ___________________________________________
Print Name of Participant: __________________________________________ Date: ____________________
PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION
(Must be completed for participants under the age of 18)
In consideration of ____________________________ (“Minor”) being permitted by ___________________ to
particiapte in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless
___________________ from all claims which are brought by or on behalf of Minor and which are in any way connected
with Minor’s use or participation. I have full authority to sign this agreement on behalf of Minor.
Signature of Parent or Guardian: _________________________________________
Print Name of Parent or Guardian: ________________________________________ Date: _______________
Release of Liability and Assumption of Risk
