11th ANNUAL THANKSGIVING OUTREACH

PRE-REGISTRATION FORM

DRIVER/VOLUNTEER WAIVER AND RELEASE FROM LIABILITY AND INDEMNITY
HOLD HARMLESS AGREEMENT

PLEASE NOTE:

By completing this form you agree to the following:

I agree on my behalf and on behalf of my heirs, personal representatives, successors and assigns hereby release and hold harmless Lambda Theta Phi, Latin Fraternity Inc., Alpha Iota Chapter at California State University, Long Beach from and against any claim for injury, including death, or loss or damage to my personal property that may be sustained by me from and during the use of my vehicle while attending the 11th Annual Thanksgiving Outreach conducted by Lambda Theta Phi, Latin Fraternity Inc., Alpha Iota Chapter at California State University, Long Beach.

This release extends to any and all claims I have or may have against the released parties, even if such claims result from strict liability or negligence on the part of any or all of the released parties, concerning the event which I will be driving, a passenger or volunteering during the Thanksgiving Outreach.

I hereby state and represent that I am experienced in and familiar with the operation of my vehicle; I hold a current, valid Driver’s License;  I hold a current insurance policy; I fully understand the risks and dangers inherent in driving or being a passenger, I am voluntarily participating in the Thanksgiving Outreach knowing the existing weather, road and other similar conditions and factors associated with the driving; and I expressly agree to assume the entire risk of any personal injury, including death, which I might suffer as a result of my participation in this Thanksgiving Outreach.

IF ANY PROVISION OF THIS WAIVER AND RELEASE SHALL BE DECLARED BY A COURT OF COMPETENT JURISDICTION TO BE INVALID OR UNENFORCEABLE, THE REMAINDER OF THIS WAIVER AND RELEASE SHALL NOT BE AFFECTED THEREBY AND SHALL BE ENFORCED TO THE FULLEST EXTENT PERMITTED BY LAW.

BY SIGNING BELOW, I DISCLOSE THAT I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS AND CONDITIONS STATED HEREIN.

THIS IS A RELEASE –PLEASE READ BEFORE SUBMITTING:

 

 

First Name

  

Last Name

 

Company/Org Name

 
Street Address:  
City  
State  
Zip  

Email Address

  
Phone Number (optional):  
Number of members volunteering:  
Are you willing to help out by driving?  
   

 

You can also sign and attach (link pdf copy I emailed you here) a copy of your singed waiver to lambdathetaphi@csulb.edu.

Thank you in advance,

Lambda Theta Phi, Latin Fraternity Inc.

ALpha Iota Chapter

California State University, Long Beach