Affidavit of Understanding, Release and Waiver of
Liability, and Assumption of Risk
Please read carefully.
IN CONSIDERATION of being permitted to observe, work for, volunteer for, or participate in
any manner whatsoever in the activities of Ella Austin Community Center, you, individually, and
as a personal representative to yourself, your heirs, assigns and next of kin, ACKNOWLEDGE,
AGREE, AND REPRESENT the following:
I ___________________________________________ (PRINT YOUR FULL LEGAL NAME),
the undersigned, being an adult (age 18 or older), or parent/guardian of a child under the age of
18, intend to participate in one or more of the Activities listed below.
Ella Austin Community Center activities (the “Activities”) include:
Gardening
Outreach opportunities
Use of recreational equipment
Art programs
Swimming
Science programs
Field Trips
Culinary programs
Transportation to and from activity areas
Other activities associated with events
I understand and acknowledge that (a) there are inherent risks, dangers and hazards in
participation in any of the Activities; (b) participation in any of the Activities may result in
injury, illness or loss, including, without limitation, disease, bodily injury, strains, fractures,
partial or total paralysis, disability or death; and (c) these risks may be caused by the negligence
of the participants, the negligence of others, accidents, breaches of contract, the forces of nature
or unforeseeable risks. (____) Initial
I understand and agree that Ella Austin Community Center and their respective employees,
officers, agents, members, trustees, beneficiaries, affiliates, volunteers, supports, sponsors, and
assigns (the "Released Parties") shall not be liable or responsible in any way for any injury, death
or other damages that may occur as a result of participation in the Activities. I agree to
indemnify, defend and hold harmless the Released Parties from any claim or lawsuit for personal
injury, property damage, or wrongful death by me, or my family, estate, heirs, or assigns, relating
in any way to the Activities. (____) Initial
I hereby assume all risks and all responsibility for any losses and/or damages in any way relating
to participation in the Activities. (____) Initial
I hereby waive, release, and discharge Ella Austin Community Center from each and every claim
whatsoever relating to participation in any of the Activities. (____) Initial
I understand and agree that (a) the sole proper venue for any dispute in which Ella Austin
Community Center is a party and that may arise out of this Agreement, or otherwise relate to
participation in any of the Activities, shall be Bexar County, Texas; (b) the dispute shall be
decided, at the sole option of Ella Austin Community Center, by litigation or arbitration. In the
event that Ella Austin Community Center elects litigation, the venue for any action shall be the
Superior Court of Bexar County; (c) this Agreement shall be interpreted pursuant to the laws of
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Affidavit of Understanding, Release and Waiver of
Liability, and Assumption of Risk
the State of Texas, which shall be controlling in all respects and at all times. (____) Initial
In the event that photographs, slides, or video tapes are made of me, I hereby authorize Ella
Austin Community Center and their partners to use, reproduce, and/or publish photographs
and/or video that may pertain to my image, likeness and/or voice without compensation. I
understand that this material may be used in various publications, social media, public affairs
releases, promotion and recruitment materials, broadcast public service advertising (PSAs), or
for other related endeavors. This material may also appear on Ella Austin Community Centers’
Internet webpage, blog, and social media pages. This authorization is continuous and may only
be withdrawn by my specific rescission of this authorization.
I consent to the release of photographs and videos of me: ☐ Yes ☐ No
I HAVE CAREFULLY READ AND UNDERSTAND THIS RELEASE AND WAIVER OF LIABILITY AND
ASSUMPTION OF RISK AGREEMENT. BY SIGNING IT I AGREE TO RELEASE AND DISCHARGE
ELLA AUSTIN COMMUNITY CENTER AND RELEASED PARTIES FROM ANY AND ALL LIABILITY
FOR CLAIMS FOR PROPERTY DAMAGE, PERSONAL INJURY, SPECIAL DAMAGES, INCLUDING
INDIRECT DAMAGES, AND WRONGFUL DEATH RELATING TO PARTICIPATION IN ANY OF THE
ACTIVITIES, EXCEPT FOR ANY CLAIMS THAT ARE THE DIRECT RESULT OF THE ACTIVE
NEGLIGENCE OF ELLA AUSTIN COMMUNITY CENTER.
________________________________________________
Print Name
________________________________________________
Signature
___________________
Date
________________________________________________
Email Address
________________________________________________
Phone Number
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Yes
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