Release Form

READ THIS CAREFULLY. BY SIGNING, YOU AGREE TO RELEASE PARTIES INVOLVED IN THE EVENT DECSRIBED BELOW, INCLUDING RELEASE OF ALL CLAIMS FOR PHYSICAL AND EMOTIONAL INJURIES (INCLUDING DEATH), PROPERTY AND OTHER DAMAGES AND LIABILITIES OF ANY KIND INCLUDING ANY THAT MAY BE DUE TO THE NEGLIGENCE, GROSS NEGLIGENCE OR CARELESSNESS OF THE RELEASED PARTIES.

With Carson
RELEASE AND INDEMNITY AGREEMENT

I am signing this Release and Indemnity Agreement (“this Release”) in anticipation of participation by me and by my minor child or children who are named below (“My Children”, whether one or more), or both, in the following activity (the “Event”) that will be planned, sponsored, conducted and/or supervised, in whole or in part, by WITH CARSON, a Texas non-profit corporation:____________________________________________________ _______________________________________________________________.

The term “Released Parties” means WITH CARSON and its officers, directors, members, agents, employees, counselors, contractors, staff, members, representatives, successors and assigns.

I realize that, by the nature of the Event, there are inherent risks of physical and emotional harm or injury, death and property damage. I am signing and delivering this Release for myself and for My Children in any and all relevant capacities. I am either the natural or adoptive parent or legal guardian of all of My Children and I have full power and authority to execute and deliver this Release for myself and for My Children.

IN CONSIDERATION FOR WITH CARSON’S CONSENT TO PARTICIPATION IN THE EVENT BY ME OR BY MY CHILDREN, OR BOTH, I HEREBY AGREE AS FOLLOWS:

1. WAIVER AND RELEASE. I, for myself and My Children, hereby waive and release all “Released Parties” from any and all claims, lawsuits, causes of action, loss, costs, expenses, damages, obligations, physical and emotional injury and harm (including death) and liabilities of any kind, whether known or unknown, and whether now existing or that may arise in the future, including attorneys fees and costs of investigation and litigation, arising out of or related in any way or manner to my participation or presence or to the participation or presence of any or all of My Children in or at the Event (collectively “Claims”), EVEN TO THE EXTENT THAT THE BASIS FOR ANY CLAIMS IS DUE IN WHOLE OR IN PART TO THE NEGLIGENCE, GROSS NEGLIGENCE OR CARELESSNESS OF ANY ONE OR MORE OF THE RELEASED PARTIES.


2. INDEMNITY AND HOLD HARMLESS. I, for myself and My Children, hereby agree to, at all times hereafter, indemnify and hold the Released Parties harmless from all Claims, EVEN TO THE EXTENT THAT THE BASIS FOR ANY CLAIMS IS DUE IN WHOLE OR IN PART TO THE NEGLIGENCE, GROSS NEGLIGENCE OR CARELESSNESS OF ANY ONE OR MORE OF THE RELEASED PARTIES.

3. ASSUMPTION OF RISKS. I, FOR MYSELF AND MY CHILDREN, EXPRESSLY ASSUME RESPONSIBILITY FOR ALL RISKS, WHETHER KNOWN OR UNKNOWN, IN MY OR OUR PARTICIPATION IN OR AT THE EVENT, EVEN TO THE EXTENT THAT THE BASIS FOR ANY SUCH MATTERS IS DUE IN WHOLE OR IN PART TO THE NEGLIGENCE, GROSS NEGLIGENCE OR CARELESSNESS OF ANY ONE OR MORE OF THE RELEASED PARTIES.

4. ACTIVITIES. I understand and acknowledge that the activities in or at the Event may be hazardous, may have inherent risks and that they may include, but are not limited to, ____________________________________________________________ _______________________________________________________________.

5. RELEASE PROVISIONS BROADLY INTERPRETED. The terms of this Release are intended to be interpreted as broadly in favor of the Released Parties as permitted by Texas law, and to provide as comprehensive a waiver, release, and indemnification of each Released Party as is possible.

6. CONSENT FOR USE. I give my consent for WITH CARSON to use any photograph or other reproduction or likeness of me or My Children, or both, without compensation or remuneration and without further consent from me, in any promotional materials or information or any program or activity sponsored, conducted or supervised, in whole or in part, by WITH CARSON.

7. MISCELLANEOUS. If any part of this Agreement is held invalid, illegal, inoperative or unenforceable for any reason, then the failure of such part will not invalidate any other part herein which will remain in full force and effect. Any rule, statute or common law of interpretation to the effect that ambiguities are to be resolved against the drafting Party does not apply to interpretation of this Agreement. This Agreement is governed by the Laws of the State of Texas and venue for any action or legal proceeding arising out of or related to any Claim or this Agreement will be in Travis County, Texas, the county in which the principal office of WITH CARSON is located.

8. I VOLUNTARILY SIGN THIS RELEASE. I have read this Release and understand it. I am voluntarily signing and delivering it without any pressure or coercion whatsoever. There have been no oral representations, promises, statements, or inducements made to me to encourage or facilitate my signing, other than as a condition of my participation or the participation of My Children, or both, in or at the Event.

I HAVE CAREFULLY READ THIS RELEASE AND UNDERSTAND THAT IT IS A WAIVER, RELEASE AND INDEMNITY OF ALL POTENTIAL CLAIMS BY ME, INDIVIDUALLY, AND ON BEHALF OF MY CHILDREN AGAINST ANY OF THE RELEASED PARTIES FOR DEATH, PERSONAL AND EMOTIONAL INJURY AND HARM, PROPERTY DAMAGE, AND OTHER DAMAGE EVEN TO THE EXTENT THAT THE BASIS FOR ANY OR ALL SUCH MATTERS IS DUE IN WHOLE OR IN PART TO THE NEGLIGENCE, GROSS NEGLIGENCE OR CARELESSNESS OF ANY ONE OR MORE OF THE RELEASED PARTIES.

9. MY CHILDREN. The term “My Children” means the following (whether one or more): [Please Print]

Name Date of Birth Residence Address
_______________________ ______________ ________________________
_______________________ ______________ ________________________
_______________________ ______________ ________________________

This Release is binding upon me, My Children, my heirs, executors, administrators, representatives, successors and assigns and those of My Children.

Signed and Delivered this _____ day of ________________, ______.



Signature:______________________________________________

Printed Name:___________________________________________

Address:________________________________________________

________________________________________________

Phone(s):(_____)______________ (_____)______________

Email Address(es): _____________________________________