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Waiver and Release of Liability Agreement

Thank you for taking the time to fill out the Youth Personal Consent Data, Consent to Attend Program, and Consent to Treat if Necessary form. Now that you have consented to attend Heart to Heart - WY activities, there is one last thing we need from you. 

Waiver and Release of Liability Agreement

In exchange for the opportunity to participate in Heart to Heart - WY Activities, I agree to the following: Heart to Heart - WY, and its respective personnel, commissioners, directors, officers, employees, volunteers, and sponsors, will not be responsible for, nor legally liable for, any damage or loss of property or bodily or personal injury or death suffered in conjunction with any activities associated with Heart to Heart - WY Activities, regardless of fault. I hereby assume all risk of damage, injury, or death arising out of or resulting from my participation in any Heart to Heart - WY Activities, including but not limited to inherent risks of any sport or recreational opportunity as defined pursuant to the Wyoming Recreation Safety Act, Wyoming Statutes 1-1-121 through 1-1-123.

 

I agree to release, hold harmless, and waive all claims against Heart to Heart - WY, and its respective personnel, commissioners, directors, officers, employees, volunteers, and sponsors, from any and all liability or cause of action arising out of any injury or death to person or property, and any other loss, damage, or expense arising out of participation in, or any activity associated with these events.

 

Should it be required during the event, I authorize medical treatment by a qualified medical professional.

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I have read and understood this Waiver and Release of Liability Agreement. I have voluntarily signed this release.

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If the person executing the foregoing release is a minor, the following section must be completed:

 

I represent that I am a parent or legal guardian of the minor who has signed the above release, and I hereby agree that we both shall be bound by it.

You are not alone

You are a warrior

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Heart to Heart                 WY

hearttoheartwy@gmail.com

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(307) 271-0363

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"To make mental health awareness more accessible, acceptable, and easier to talk about within Park County, before expanding into other cities, counties, and states."

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