Esso Annuitant Club Toronto North (EACTN)

Assumption of Risk, Waiver and Release

Activity: ______

Date: ______Activity Leader(s): ______

PLEASE READ THE FOLLOWING CAREFULLY:

In consideration of being permitted to participate in the above Esso Annuitant Club Toronto North (“EACTN”) activity (“Activity”), and in full recognition and appreciation of the dangers and risks inherent in participation in this Activity, I do hereby waive, release and forever discharge all EACTN executives, volunteers, members and other Activity participants from and against all claims, demands, actions or cause of actions for costs, expenses or damages to personal property or personal injury, or death, which may result from my participation in the Activity.

I understand and declare that my participation in this Activity is voluntary. I assume full responsibility for any injuries or damages resulting from my participation in this Activity, including responsibility for using appropriate judgment in all phases of the Activity. I am aware that EACTN does not carry any liability insurance.

I affirm that I am in good health and further declare that I am at an appropriate level of physical fitness and physical capability to participate in this Activity. I also understand that this Assumption of Risk, Waiver and Release binds my heirs, executors, administrators and assigns as well as myself.

I acknowledge that I have read and understand this Assumption of Risk, Waiver and Release and I agree to be legally bound by it.

PARTICIPANTS

Name (print) / Signature / Emergency name & phone number (print)
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Esso Annuitant Club Toronto North (EACTN)

Assumption of Risk, Waiver and Release

Activity: ______

Date: ______Activity Leader(s): ______

PLEASE READ THE FOLLOWING CAREFULLY:

In consideration of being permitted to participate in the above Esso Annuitant Club Toronto North (“EACTN”) activity (“Activity”), and in full recognition and appreciation of the dangers and risks inherent in participating in this Activity, I do hereby waive, release and forever discharge all EACTN executives, volunteers, members and other Activity participants from and against all claims, demands, actions or cause of actions for costs, expenses or damages to personal property or personal injury, or death, which may result from my participation in the Activity.

I understand and declare that my participation in this Activity is voluntary. I assume full responsibility for any injuries or damages resulting from my participation in this Activity, including responsibility for using appropriate judgment in all phases of the Activity. I am aware that EACTN does not carry any liability insurance.

I affirm that I am in good health and further declare that I am at an appropriate level of physical fitness and physical capability to participate in this Activity. I also understand that this Assumption of Risk, Waiver and Release binds my heirs, executors, administrators and assigns as well as myself.

I acknowledge that I have read and understand this Assumption of Risk, Waiver and Release and I agree to be legally bound by it.

PARTICIPANTS

Name (print) / Signature / Emergency name & phone number (print)
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