Waiver and Release of Liability Form
I, ON BEHALF OF MYSELF , HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES PROVIDED BY THE Qalam Institute, Inc. (“Qalam”) as may be required by my job, participation, or my volunteering, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
I certify that there are no health-related reasons or problems which preclude my participation in QALAM activities, or I have provided written notice to QALAM or its assign of such conditions nor have I traveled in the most recent 14 days prior to execution of this Waiver and Release.
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, INCLUDING BUT NOT LIMITED TO, LIABILITY ARISING FROM THE NEGLIGENCE OR FAULT OF THE ENTITIES OR PERSONS RELEASED, FOR MY DEATH, DISABILITY, PERSONAL INJURY, PROPERTY DAMAGE, PROPERTY THEFT, OR ACTIONS OF ANY KIND WHICH MAY HEREAFTER OCCUR TO ME INCLUDING ANY CONSUMPTION OF FOOD ITEMS OR COVID-19 EXPOSURE, THE FOLLOWING ENTITIES OR PERSONS: QALAM INSTITUTE, INC. AND/OR THEIR DIRECTORS, OFFICERS, EMPLOYEES, VOLUNTEERS, REPRESENTATIVES, AND AGENTS, AND THE ACTIVITY HOLDERS, SPONSORS, AND VOLUNTEERS;
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE THE ENTITIES OR PERSONS MENTIONED IN THIS PARAGRAPH FROM ANY AND ALL LIABILITIES OR CLAIMS MADE AS A RESULT OF PARTICIPATION IN THIS ACTIVITY, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEE OR OTHERWISE. ANY DISPUTE THAT ARISES SHALL BE BROUGHT FORTH TO A MUTUALLY AGREED ARBITRATOR WHOSE DECISION SHALL BE BINDING UP ALL PARTIES.
(C) I will notify my immediate supervisor or QALAM representative of any health conditions that preclude my ability to participate in Qalam activities, perform services for QALAM or may arise during my service to QALAM. I will comply with all requirements of QALAM to participate or provide services for QALAM activities.
I acknowledge that QALAM and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.
The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, COVID-19 infection or exposure and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers and employees or contractors.
I hereby consent to receive medical treatment which may be deemed advisable and necessary in the event of injury, accident, and/or illness during this activity.
The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.