Accident Waiver and Release of Liability 

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS ACTIVITY OR EVENT, 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 I am physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional.  I certify that I have no physical or mental health-related illness that precludes my participation in this activity in a safe manner for myself or others.

I agree that all staff or authorized agents may, in their sole discretion, determine it is unsafe for myself or others for my participation to continue, and remove me from the premises by any lawful means.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.

I acknowledge that the Winchendon History and Cultural Center is not held liable to distribute refunds.

In consideration of my application and permitting me to participate in this activity, 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, THE FOLLOWING ENTITIES OR PERSONS: The Winchendon History and Cultural Center and/or its directors, officers, employees, volunteers, representatives, and agents of any and all entities authorizing, holding, or sponsoring this activity; 

(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 release or otherwise.

I acknowledge that the Winchendon History and Cultural Center 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 event or activity on behalf of the Winchendon History and Cultural Center. 

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event.  

I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose this authorizing entity decides, and assigns.

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 understand that anyone younger than 18 years of age, must acquire parent or guardian signature. Any persons younger than 12 years of age must be accompanied by a parent or guardian. 

I CERTIFY THAT I HAVE READ THE WINCHENDON HISTORY AND CULTURAL CENTER ACCIDENT WAIVER AND RELEASE OF LIABILITY CONTRACT. I FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT, AND SIGN IT OF MY OWN FREE WILL.

Download the Accident Waiver and Release of Liability contract by clicking here.