Activity Waiver Form

Activity Waiver & Release: By logging onto this website and registering for “The Flobel Angels” program, the Participant agrees to the following:

  1. Consideration
    Being of lawful age and in consideration of being permitted to participate in the activity described below, the Participant releases and forever discharges The Gray Panthers and The Florence Belsky Charitable Foundation (“the Activity Platform” or sometimes “Flobel”) , the Activity Platform’s agents, employees, heirs, executors, administrators, legal representatives and assigns from all manner of actions, causes of action, debts, accounts, bonds, contracts, claims and demands for or by reason of any injury to person or property, including injury resulting in the death of the Participant, which has been or may be sustained as a consequence of the Participant’s participation in the activity described below, and not withstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Activity Provider.
    The Participant understands that the Participant would not be permitted to participate in the activity described below unless the Participant signed this Agreement.
  2. Details of Activity
    The Participant will participate in the following activity: Giving mutual assistance to others and receiving same from other Participants.
  3. Concurrent Release
    The Participant acknowledges that this Agreement is given with the express intention of effecting the extinguishment of certain obligations owed to the Participant and with the intention of binding the Participant’s spouse, heirs, executors, administrators, legal representatives and assigns.
  4. Fitness to Participate
    The Participant acknowledges that the Participant does not have any physical limitations, medical ailments, physical or mental disabilities that would limit or prevent the Participant from participating in the above mentioned activity. If required, the Participant will obtain a medical examination and clearance.
  5. Full and Final Settlement
    The Participant hereby acknowledges and agrees that the Participant has carefully read this Agreement, that the Participant fully understands the same, and that the Participant is freely and voluntarily executing the same and assuming all risks (known and unknown) in the activities.
    The Participant understands that by signing this Agreement, the Participant agrees to be forever prevented from suing or otherwise claiming against the Activity Provider and/or Flobel and /or The Gray Panthers for any property loss or personal injury that the Participant may sustain while participating in or preparing for the above noted activity.
    The Participant has been given the opportunity and has been encouraged to seek independent legal advice prior to signing this Agreement.
    This Agreement contains the entire agreement between the parties to this Agreement and the terms of this Agreement are contractual and not a mere recital.
  6. Indemnification
    Participant agrees to indemnify The Activity Platform from and against any claims. Demands, causes of action, obligations, liability, loss, damage, cost and expenses (including reasonable attorneys’ fees) , incurred or sustained by reason of or arising out of the noted activity. The Gray Panthers and/or Flobel shall have choice of counsel in defending any such claim.
  7. Governing Law
    This Agreement will be governed by and construed in accordance with and governed by the laws of the State of New York.
  8. Emergency Contact (optional): Please email us the name, phone number and email address of your emergency contact to info@flobelangels.org