Governing Jurisdiction:
Purpose of Waiver/Release:
Purpose of Waiver/Release This release may be used by the Releasor, to allow himself, his child, or his pet to participate in an activity. Alternately, it may be used by the Releasor to release a claim against another person, or that person's pet or child. Personal injury is considered vicarious if the Releasee is legally responsible but was not directly involved in the incident (e.g., a person is vicariously liable if they lend their car to a friend, and their friend hits a pedestrian). A mutual release is used when both parties are releasing their claims against each other.
Participant's Contact Information:
Participant's Contact Information:
Participant's Contact Information:
First Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Releasor's Contact Information:
Important Notice It is important to note that, by signing this agreement, the Releasor is releasing ONLY the Releasee. The Releasor may still have claims against other people involved (e.g. the Releasee's child, or the driver of the Releasee's vehicle).
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Second Releasor's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Releasee's Contact Information:
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe how the debt arose
Date of the Original Debt:
Use complete sentences to explain how the debt arose
Date of the Original Debt:
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Use complete sentences to describe events and their causes
Signatures Required:
Signatures Required To ensure the validity of this agreement, we recommend the presence of a notary public or at least one witness
Date of Signing, if known:
Location of Signing:
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