NAH Field Trip/Activity Sign-up & Waiver

NAH Field Trip/Activity Sign-Up & Waiver

Name

Email Address (to receive a copy of this form):

Please select

I have been employed by Newberry Animal Hospital for 60 days or longer:

Yes

I am attending my NAH location's upcoming field trip activity:

Yes

Required Acknowledgement 1:

I understand that if I RSVP to my location's activity & I do not show up on the day of the activity, the cost of the ticket will be deducted from my paycheck.

Required Acknowledgement 2:

I understand my ticket that was provided to me only covers my admission into the park or activity space. I understand that I may have to pay for parking, food, or any additional activities I may want to add on to my experience.

Liability Waiver & Release

PLEASE READ THE FOLLOWING carefully before signing this waiver. I acknowledge and agree to the terms and conditions of this liability waiver and assumption of risk identified as:

Liability Waiver & Release: I understand and acknowledge that this Liability Waiver & Release discharges Newberry Animal Hospital Group, its owners, and employees from all claims, damages, losses, injuries, and expenses incurred during this field trip/activity. I do hereby acknowledge that I understand the risks associated with the equipment used during this activity and the activity itself. I release, indemnify, forever discharge, and hold harmless Newberry Animal Hospital Group, its owners, and employees from any and all liability claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from this field trip/activity.

Assumption of Risk: I recognize and understand that this field trip/activity may involve inherently dangerous activities. There are risks, both known and unknown, when participating in the activities of this trip including but not limited to physical injury, emotional injury, distress, paralysis and even death. The risk of serious injury from participating in physical activity such as will be present on this field trip/activity - although minimal - does exist, as it does in all play and amusement activities. I understand and acknowledge that this release discharges Newberry Animal Hospital Group, its owners, and employees from injury, illness, death, or property damage resulting from the activities performed on this field trip/activity. I expressly agree that this release is intended to be as broad and inclusive as permitted by state and federal law. I agree that in the event that any clause or provision shall not otherwise affect the remaining provisions of this release which shall continue to be enforceable.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY AGREEMENT, FULLYUNDERSTAND ITS TERMS AND FULLY UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS FOR MYSELF AND THOSE FOR WHOM I HAVE ASSUMED RESPONSIBILITY. BY MY SIGNATURE, I FREELY AND VOLUNTARILY AGREE TO THESE TERMS.

Date

YYYY

Signature

Verification