Pennsylvania Volunteer Liability Release Form

VOLUNTEER RELEASE AND WAIVER OF LIABILITY FORM
This Release and Waiver of Liability (the “release”) executed on this ______ day of _____________, 2011,
by_________________________________ hereby releases the following Persons and Entities Released
(Name of Volunteer)
and otherwise agrees as follows:
Persons and Entities Released: Enjoy Bellevue, Antique Mall/Ohio River, Klauscher Architects, the Commonwealth
of Pennsylvania, all Committee personnel and all affiliated Sponsors (the participating entities), and all others,
jointly, severally, and individually.
The Volunteer desires to provide volunteer services and engage in activities related to serving as a volunteer for
The First Ever Bellevue Haunted House and Spooktacular Event to be operated by Enjoy Bellevue. A private entity
not affiliated with the Borough of Bellevue, the above named volunteer hereby agrees as follows:
1.
WAIVER AND RELEASE: I, the Volunteer, release and forever discharge and hold harmless the above listed
entities from any an all liability, claims, and demands of whatever kind or nature, either in law or in equity, which
arise or may hereafter arise from the services I provide. I understand and acknowledge that this Release
discharges from any liability or claim that I may have with respect to bodily injury, personal injury, illness, death,
or property damage that may result from the services I am providing for The Event.
2.
INSURANCE: Further I understand that none of the above participating entities assumes any responsibility for
or obligation to provide me with financial or other assistance, including but not limited to medical, health or
disability benefits or insurance of any nature in the event of my injury, illness, death or damage to my property. I
expressly waive any such claim for compensation or liability on the part of the participating entities.
3.
MEDICAL TREATMENT: I hereby Release and forever discharge the participating entities from any claim
whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services
rendered in connection with an emergency during my tenure as a volunteer with the Event.
4.
ASSUMPTION OF RISKS: I understand that the services I provide to the Event may include activities that may
be hazardous to me including, but not limited to involving inherently dangerous activities. As a volunteer, I
hereby expressly assume the risk of injury or harm from these activities and Release ALL participating entities
from all liability for injury, illness, death, or property damage resulting from the services I provide as a volunteer
or occurring while I am providing volunteer services for The Event.
5.
PHOTOGRAPHIC RELEASE: I grant and convey to the event organizers all right, title, and interests in any and
all photographs, images, video, audio in connection with my providing volunteer services for The Event.
6.
OTHER: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as
permitted by the laws of the State of Pennsylvania and that this Release shall be governed by and interpreted in
accordance with the laws of the State of Pennsylvania. I agree that in the event that any clause or provision of
this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be
affected.
By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability
willingly and voluntarily.
________________________________
Signature
___________
Age
______________________
Date
If volunteer is under the age of 18, a parent/guardian must read and sign this Release/Waiver of Liability form.
___________________________________
________________________
Parent or Guardian
Date