Liability Release Form

(the "Participant")

In consideration for the Participant’s participation in all activities of Western Connecticut Leadership program (the “Program”) sponsored by the Connecticut Community Foundation, the undersigned Participant, being legally competent, for myself and my heirs, executors, administrators, and personal representatives hereby: 

1. Acknowledges that I am voluntarily participating in the Program, fully understand that the Program may involve the risk of injury, sickness, death, damage, and expense, and agree to assume any such risk involved with respect to myself; 

2. Understands that some dangers that I may face include, but are not limited to: travel by auto, bus, boat or other conveyance, or on foot, or other form of active or passive travel; consumption of food, or of alcoholic or non-alcoholic beverages; and the breakdown of equipment; 

3. Releases and forever discharges the Connecticut Community Foundation, its affiliates and related parties, and their respective successors, directors, officers, members, employees, volunteers, and agents (the “Releasees”), from any and all damages, attorney fees, expenses, liability, claims, or demands for personal injury, sickness, or death, as well as for property damage and expenses, of any nature whatsoever (including, without limitation, attorney’s fees and expenses) (the “Claims”), that may be incurred or suffered by me arising from, or related to, the Program, including but not limited to the negligence of the Connecticut Community Foundation , its affiliates or related parties, or their respective successors, officers, directors, employees, members, volunteers, or agents; 

4. Indemnifies and holds the Releasees harmless for all Claims arising from or related to my own negligent, willful or intentional acts during the Program; and 

5. Acknowledges that I have carefully read and understand all matters covered by this Liability Release Form (this “Release”), WHICH PROVIDES FOR THE LEGALLY ENFORCEABLE WAIVER OF RIGHTS, and sign this Release voluntarily. 

This Release, which contains the entire agreement with respect to the foregoing matters, shall be governed by and construed in accordance with the laws of the State of Connecticut.

IN WITNESS WHEREOF, the Participant has signed this Release effective as of the date first set forth above. 

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