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<br />GEC TREE PLANTING PROJECT
<br />PROJECT SIGN IN AND WAIVER '
<br />Please print legibly
<br />To Be Completed by all volunteers
<br />Name
<br />Address
<br />City/State/Zip
<br />Phone (w)
<br />(h)
<br />Company or Group Name, if applicable
<br />WAIVER AND RELEASE AGREEMENT
<br />THIS IS A RELEASE OF LIABILITY. PLEASE READ CAREFULLY BEFORE
<br />SIGNING.
<br />In B[ura [or acting as a volunteer for the Colorado Division of Minerak end Geology (DMG) oo [he GEC Tree Fleeting project ao
<br />,1995, I epee ro aaume all risks of lass and injury that may arise out o[ my pertidpatica and I agree to waive my
<br />and all deims against DMG.
<br />1 hereby Rlraee ,and egRe to indemnify end hold Wrmlese DMG and all oNer projeel participaets, end thew respective agents,
<br />RpRdCnntlYe, ofriRq employees, sueoceors, assiprs, end latURrs, hCRIMf[Cr R(CrRd 10 as'the Releases', from any end ell liability,
<br />Mimq demands, or ectioru or cause of action whatsoever, arising out of damage, lass, or injury to my person or Property, whether
<br />anticipated or unsn[idpated, while partiripathtg is any o[ the activities toetemplated by this egRemeot, whether such damagr, twee, or injury
<br />Rsul[e from the oegligeooe o(the Releases, their Rcpective agents, otriars, employees, eucroessors, assigns and insurers or from come other
<br />ease. This Rkate and agreement shall be binding upon me, my heirs, euooeaors, assigns, edmiaistrators end emeutora [ undersuad
<br />Chet my Rletimship with the DMG is not an employertmployee relationship and that I em not eetitled to workefe oompensatioo benefits
<br />is my epedry at a volunteer.
<br />I erpRSly acknowledge, repRaet and agree slut esprealy idenri(ying and ezpbcitly naming the rapeetive agrnts, Rpreeenutives, otrioers,
<br />employee, aro~oq assigns, and insuRrs d the partic Bleated, all o[ whom I intend to be Bleated by this docvmcet, a a pnctiel
<br />impasabr7iry (or the parties. The uodersipred and the partic Rfeascd heRin exprcaly acknowledgr the[, for good and valuebk
<br />eoosideratioa, the terms 'repective agents, represeotetive, offiars, employees, wocrssors, eaigat and insuRrs', however used in this
<br />Waiver end Release Apeemeat aR espRssly and ercphcitly intended to include all wad tech and every individual, person, rum, entity and
<br />mrpontiao who aR now, or at my time may have been included in the epecifieally listed categoric.
<br />1 .caWG that working Om this project may iawlve the 1LSe o[ toots 8t well 85 other risla and herarts. I will be worldeg around other
<br />panicipanfe who may net be smatomrA to this type o[ labor. I am awaR of the rttl[5 end hararde iahereet in participating end do hereby
<br />eseume role Rspoacibiliry [or all each risks and waiver all claims against the Releases, We'u respective agrnts, Bprrxnutivee, ol~Rrs,
<br />employees, strocessors, assigns and inavRrs.
<br />I hereby acknowedgr that 1 have Bad, uoderalooQ and wlunurily agreed to the foRgouog waiver and Reease agreement.
<br />Srg118tUR
<br />Perron to coauct in case o[ emergency
<br />Date
<br />Name Phone
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