Georgia Release of Liability
This Release of Liability is made on the ___ day of __________, 20___, by and between:
Participant's Name: ________________________________________
Address: ________________________________________________
City, State, Zip: ________________________________________
and
Organization/Provider’s Name: ___________________________
Address: ________________________________________________
City, State, Zip: ________________________________________
In accordance with Georgia law, this document serves to acknowledge the risks associated with participation in activities organized by the above-named provider and to release them from any liability.
1. Description of Activities: The activities covered by this Release include, but are not limited to:
- ____________________________________________
- ____________________________________________
- ____________________________________________
2. Acknowledgment of Risk: I understand that participation in these activities may involve certain risks, including but not limited to the risk of injury, illness, or death. I acknowledge that I have been informed of these risks and voluntarily assume them.
3. Release of Liability: I, the undersigned participant, hereby release and hold harmless the Organization/Provider, its officers, employees, agents, and volunteers from any and all liability for injuries or damages that may arise from my participation in the activities.
4. Indemnification: I agree to indemnify and defend the Organization/Provider from any claims, demands, and causes of action that may arise out of my participation.
5. Governing Law: This Release shall be governed by and construed in accordance with the laws of the State of Georgia.
By signing below, I affirm that I have read and understood the contents of this Release of Liability. I understand that I am giving up certain legal rights, and I do so voluntarily.
Participant’s Signature: __________________________________
Date: ________________________________________________
Emergency Contact Name: _____________________________
Emergency Contact Phone Number: ______________________