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In order to access the Makerspace facility and services at the Edmonton Public Library all customers must fill out this waiver.

ASSUMPTION OF RISK

I understand and accept that there may involve certain risks, dangers and hazards in the use of the Makerspace facilities at the Library. I freely accept and fully understand and assume all risks, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting therefrom.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

In consideration of acceptance into the Library’s Makerspace facility I hereby agree to waive any and all claims that I have or may in the future have against the Library.  I agree to release the Library from any and all liability for any loss, damage, injury or expense that I may suffer or that my next of kin may suffer as a result of the use of the facility due to any cause whatsoever, including negligence, breach of contract or breach of any statutory or other duty of care on the part of the Library.  I agree to hold harmless and indemnify the Library from all liability for any property damage or personal injury or loss to any third party arising from my use of the Library’s Makerspace equipment. I understand and agree to the terms of service for each specific service offered by the Makerspace/Fab Lab facility of the Library.

First Customer's Name

First Name*

Middle Name

Last Name*
First Customer's Date of Birth*
First Customer's EPL Card Number

EPL Card Number *
First Customer's Signature*
Second Customer's Name

First Name*

Middle Name

Last Name*
Second Customer's Date of Birth*
Second Customer's EPL Card Number

EPL Card Number *
Third Customer's Name

First Name*

Middle Name

Last Name*
Third Customer's Date of Birth*
Third Customer's EPL Card Number

EPL Card Number *
Fourth Customer's Name

First Name*

Middle Name

Last Name*
Fourth Customer's Date of Birth*
Fourth Customer's EPL Card Number

EPL Card Number *
Fifth Customer's Name

First Name*

Middle Name

Last Name*
Fifth Customer's Date of Birth*
Fifth Customer's EPL Card Number

EPL Card Number *
Sixth Customer's Name

First Name*

Middle Name

Last Name*
Sixth Customer's Date of Birth*
Sixth Customer's EPL Card Number

EPL Card Number *
Seventh Customer's Name

First Name*

Middle Name

Last Name*
Seventh Customer's Date of Birth*
Seventh Customer's EPL Card Number

EPL Card Number *
Eighth Customer's Name

First Name*

Middle Name

Last Name*
Eighth Customer's Date of Birth*
Eighth Customer's EPL Card Number

EPL Card Number *
Ninth Customer's Name

First Name*

Middle Name

Last Name*
Ninth Customer's Date of Birth*
Ninth Customer's EPL Card Number

EPL Card Number *
Tenth Customer's Name

First Name*

Middle Name

Last Name*
Tenth Customer's Date of Birth*
Tenth Customer's EPL Card Number

EPL Card Number *
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
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*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian's EPL Card Number

EPL Card Number *
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.


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