Loading...

RELEASE AND WAIVER OF LIABILITY

I, the undersigned person, individually and as the parent or legal guardian of the minor child  (“Minor Child”), in consideration of my and/or my Minor Child being permitted to participate in activities on and otherwise to visit or use certain real property or personal property (including but not limited to any pavilion, cabin, barn or other structure or improvements thereon; livestock; equipment; vehicles and other personal property) belonging to, leased by or under the control or supervision of Purification Heritage Center, Inc., Purification Properties LLC or The Roman Catholic Archdiocese for Atlanta (or its Archbishop) for walking, hiking, camping, lodging, fishing, bicycling, viewing livestock, photography, touring or any other activity or purpose whatsoever, individually and for my heirs, beneficiaries, next of kin, estate, legal or personal representatives, successors and assigns, hereby release, waive, covenant not to sue, indemnify, and hold harmless Purification Heritage Center, Inc., Purification Properties LLC and The Roman Catholic Archdiocese for Atlanta (and its Archbishop), and each of their respective members, owners, managers, officers, directors, agents, employees, representatives, successors, assignees, and any other persons connected with any of the types of activities described above or any of the owners of the private or public property upon which any such activity is conducted (all of whom are hereinafter referred to individually and collectively as the “Released Parties”), from any and all liability, damages, costs and expenses (including without limitation attorney’s fees) arising from or incurred, directly or indirectly, for personal injury, death or property damage caused to or suffered by (i) my Minor Child, any of my family members or relatives, or me; or (ii) any other person in my group, arising from, caused by or in any way related to my Minor Child’s or my presence (or participation in any activities undertaken while present) on or use of any real property or personal property belonging to, leased by or under the control or supervision of any of the Released Parties.  I, individually and on behalf of my heirs, beneficiaries, next of kin, estate, legal or personal representatives, successors and assigns, also agree that if I make or anyone else makes any claims against any of the Released Parties because of any injury (including death) to my Minor Child, or for any damage to my Minor Child’s or my property, or the property of any other person, I will fully defend, indemnify and hold harmless all of the Released Parties from and against all liability, damages, costs and expenses (including without limitation attorney’s fees) arising from or incurred, directly or indirectly, as a result of any such claim.  Further, to the fullest extent allowed by law, I hereby waive my Minor Child’s rights and my rights, individually and as a parent or legal guardian, to sue or to bring claims of any kind against any of the Released Parties, and further covenant not to sue or otherwise bring any such claim or action individually or on behalf of my Minor Child.  I acknowledge that there is no particular necessity for my Minor Child or me to participate in any of the activities referenced or described herein, and I myself am undertaking them, and/or am permitting my Minor Child to undertake them, of my own free will and volition.  My Minor Child and I are bound by this Release and Waiver of Liability, as are the family members, heirs, beneficiaries, next of kin, estate, successors, assigns, legal guardians and personal representatives of my Minor Child or mine.  This Release and Waiver of Liability shall be construed under the laws of the State of Georgia and shall be effective from and after the date set forth below, without renewal or reaffirmation being required, from year to year for as long as my Minor Child or I participate in any of the activities referenced or described herein.

I, individually and as the parent or legal guardian of the Minor Child, hereby permit and authorize Purification Heritage Center, Inc., Purification Properties LLC and The Roman Catholic Archdiocese for Atlanta (individually and collectively, the “Authorized Party”) to use a photograph or other likeness of my Minor Child or me attending or participating in any of the activities referenced or described herein for purposes related to advertising, marketing and promoting future events, or other similar purposes, including sharing with the general public.  I understand my Minor Child’s or my photograph or likeness may be copied or distributed by means of various media, including social media, websites, email and brochures.  I understand that although the Authorized Party will endeavor to use any such photograph or likeness in accordance with standards of good judgment, the Authorized Party cannot warrant or guarantee that any further dissemination of such photograph or likeness will be subject to their supervision or control.  Accordingly, I release each Authorized Party from any and all liability related to dissemination of my Minor Child’s or my photograph or likeness.

The signature requirements of this Release and Waiver of Liability may be satisfied by procedures any Authorized Party has established or may establish from time to time for an electronic system for execution and delivery of any documents, including this Release and Waiver of Liability.  The undersigned person’s electronic signature, including without limitation “click-through” acceptance of this Release and Waiver of Liability through a website maintained by or on behalf of any Authorized Party, is the same as, and shall have the same force and effect as the undersigned person’s manual signature. Any such procedures and delivery may be implemented by or through a third party engaged by such Authorized Party to provide administrative services.

SIGNATURE OF PARENT OR GUARDIAN IS REQUIREDFOR ALL PARTICIPANTS UNDER 18 YEARS OF AGE.

Today's Date: July 30, 2021

First Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information about upcoming events and news by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
Parent or Guardian's Name

First Name*

Last Name*
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!