Earth Day Waiver

TOWN OF HARWINTON

WAIVER, HOLD HARMLESS AND RELEASE OF LIABILITY

In consideration for volunteering for the town's Earth Day Litter Cleanup, the undersigned hereby agrees that

l understand that there are inherent risks involved when performing Volunteer work for the Town including the risk of physical injury and l fully assume all risks associated when performing volunteer work, even if due to the negligence of the Town of Harwinton and their agents, servants or employees, including but not limited to: Lack of safety devices or inadequate safety devices; lack of warnings or inadequate warnings; lack of instructions or inadequate Instructions, and the like

I, for myself and for my heirs, assigns, successors, executors, administrators, and legal representatives, agree to defend, indemnify and hold harmless the Town of Harwinton and their agents, servants or employees from any and all claims, suits or demands by anyone arising from my use of the Town of Harwinton's facilities and equipment including claims of negligence on the part of the Town of Harwinton and their agents, servants or employees

I, for myself and for my heirs, assigns, successors, executors, administrators, and legal representatives, hereby release, and agree that I Will not sue the Town of Harwinton and their agents, servants or employees for money damages for personal injury sustained by me while volunteering to pick up roadside litter in the Town of Harwinton and/or use of equipment even if due to the negligence of the Town of Harwinton and their agents, servants or employees

I have read this waiver, hold harmless agreement and release of liability and fully understand its terms l further understand that by signing this agreement that l am giving up substantial legal rights. I have not been induced to Sign this agreement by any promise or representation, and I Sign it voluntarily and of my own free WIII.

Participant's Signature  ____________________________________________________________

Participant's Printed Name _____________________________________     Date _______________

CONSENT OF PARENT OR GUARDIAN

This is to certify that l, as parent or guardian With legal responsibility for this participant, do hereby consent and agree to his or her release as set forth above, and for myself, my heirs, assigns, successors, executors, administrators, and legal representatives, agree to defend, indemnify and hold harmless the Town of Harwinton and their agents, servants or employees from any and all claims, suits or demands by anyone arising from said participant's involvement in cleaning up roadside litter in the Town of Harwinton, the use of  facilities and equipment including claims of negligence on the part of the Town of Harwinton, and their agents, servants or employees

Parent/Guardian Signature _____________________________________

Parent/Guardian Printed Name____________________________________   Date___________________