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Liability Waiver

In consideration for receiving certain services from Hazy Dayz Moving and Hauling, LLC. (“Company”), I agree to the following Waiver and Release:

I acknowledge that packing, loading, transporting and unloading property creates certain risks to my property and my person. In particular, property can be broken, dropped, scraped, torn, scratched, lost, etc., including risks to carpets and hardwood flooring, as well as risk of loss of cash, checks, bonds, jewelry, deeds, coin and stamp collections, alcohol, prescription medications, damaged to fur or items lined with fur, particleboard furniture, firearms and/or ammunition and plasma televisions. Hazy Dayz Moving and Hauling  STRONGLY RECOMMENDS THAT YOU PERSONALLY MOVE ITEMS OF SIGNIFICANT MONETARY OR PERSONAL WORTH. Further, I could be physically injured by use of property damaged in the move, or through physical impact with furniture, boxes, or vehicles. I further understand that disconnecting, transporting, or preparing home appliances for use after transportation is dangerous and could result in injury or damages. In particular, appliances may be disconnected or installed improperly and result in flooding, electrocution or fire. COMPANY STRONGLY RECOMMENDS THAT YOU HIRE A PROFESSIONAL SERVICE PROVIDER TO DISCONNECT AND INSTALL ALL APPLIANCES. I acknowledge that the disconnection and installation of home appliances is my personal responsibility and not Company’s. I, for myself, my heirs, successors, executors and subrogates, hereby KNOWINGLY AND INTENTIONALLY WAIVE AND RELEASE, INDEMNIFY AND HOLD HARMLESS COMPANY, its directors, officers, agents, employees and volunteers from and against any and all claims, actions, causes of action, liabilities, suits, expenses (including reasonable attorneys’ fees) for damages to my property or person resulting from Hazy Dayz Moving and Hauling’s NEGLIGENCE during the move or resulting from an improperly disconnected or improperly installed home appliance.

Notwithstanding, the foregoing, I acknowledge Company is only responsible for $.50 per pound of damaged or missing items and that I have had the opportunity to seek a higher degree of protection through insurance. I agree that I may not bring any claim for lost or damaged items more than one (1) month after the move. By bringing a claim, I agree to permit Hazy Dayz Moving and Hauling any reasonable means to investigate my claim. I further acknowledge that Company is not responsible for the contents of any box it did not pack. And, Hazy Dayz Moving and Hauling’s responsibility only extends to items while under its care and custody and terminates when it leaves the premises.


First Services Provided To Name
First Name*
Middle Name
Last Name*
Phone*
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First Client Age Acknowledgment*
First Client Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Client Signature*
Second Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Third Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Fourth Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Fifth Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Sixth Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Seventh Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Eighth Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Ninth Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Tenth Services Provided To Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
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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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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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