Loading...

Adopt a Trail Volunteer Release of Liability

 

 

I acknowledge that I have voluntarily applied to participate in the Adopt a Trail Program with, for, or on the premises of the City of Steamboat Springs Parks and Recreation Department. 

I further acknowledge that by voluntarily participating in this activity I will not become an employee, contractor, or agent of the City of Steamboat Springs Parks and Recreation Department, and that I will not be entitled to any wages, benefits, or other privileges of employment, including Workers Compensation or other disability insurance coverage.

I understand that the activities described in the Adopt a Trail guidelines may involve risks of injury, loss, or damage to myself, including but not limited to bodily injury, personal injury, sickness, disease, death, and property loss or damage.  By signing this agreement, I expressly agree to assume any and all such risks.  I hereby expressly exempt, release, and indemnify the City of Steamboat Springs, it officers, employees, insurers, and self-insurance pool, from and against all liability, claims, demands, on account of injury, loss or damage to myself including without limitation claims arising from bodily injury, personal injury, sickness, disease, death, or property loss or damage, that I may incur as a result of my participation in the Adopt a Trail Program.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!