Community Cup Sign-Up

COMMUNITY CUP ACTIVITY ACCIDENT AND LIABILITY WAIVER & RELEASE

            I acknowledge that I am voluntarily participating in the Community Cup events, that these events involve physical activities and carry with them the potential for injury to my person and/or property loss. The risks include, but are not limited to: actions of other people that may result in my injury or property loss, such persons including, but not limited to, participants, volunteers, spectators; lack of hydration, weather, and/or other natural conditions; injury to my person, both minor and major as a result of the event(s) in which I have voluntarily chosen to participate.  I hereby assume all of the risks of my voluntary participation in these events.

            I certify that I am physically able to participate in these events and have not been advised otherwise by a qualified medical person.

            I acknowledge that this Accident & Voluntary Activity Waiver and Release of Liability form will be used by the County, South Lewis Central School District, Beaver River Central School District, Lewis County Agricultural Society (owner of the Fairgounds), Lewis County Health Systems, and all others participating in the Community Cup and/or granting access to their property for the events in which I may participate,  and will govern my actions and responsibilities in the events.

      1. In consideration of my voluntary participation in these events, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I waive, release, and discharge from any and all liability for my death, disability, personal injury, worker’s compensation claim, property damage, property theft or actions of any kind which may hereafter accrue to me or to me by my traveling to and from these events, THE FOLLOWING ENTITIES OR PERSONS:  The County of Lewis,  the Village of Lowville,  Lewis County Agricultural Society, South Lewis Central School District, Beaver River School District, Lewis County Health Systems, Otis Technologies; Naturally Lewis/County of Lewis IDA, and any other entity which may participate in these events; and each entity’s directors, officers, employees, volunteers, representatives and agents;  (B)  I indemnify and hold harmless all entities or persons mentioned in this paragraph from any and all liabilities or claims made by me or other individuals or entities as a result of my participation and actions during these events.

            This Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under the applicable law.


Community Cup Waiver and Release of Liability.pdf


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By checking this box and signing your name below you certify that you have read, understood, and agree to the Community Cup Activity Accident and Liability Waiver & Release form found at the top of this page. Your typed name below will serve as an electronic signature.
Your typed out name in this field will be treated as a genuine, formal signature and indicates that you agree to the terms of the Community Cup waiver (document and language spelled out above this form). This must be filled out along with the checkbox. Thank you.