Injury Release Form

July 9, 2011

An Injury Release Form is required by schools or institutions to protect them from any personal injury claims. School trips, swimming classes, field trips and any such activities have mandatory injury release forms that need to be signed by the participants or their guardians. The one signing the form acknowledges that he/she can get injured and takes full responsibility for those personal injuries thereby releasing the institution from any liability.

Sample Injury Release Form

I, ______________________________, hereby accept sole responsibility for any personal injury I incur during the course of this program. I acknowledge that participation in the program exposes me to potential risks and I release all employees of any and all liabilities regarding my injury. However this will not be the case if my injury was a direct result of any willful and wanton conduct.

I shall not now or in future prosecute any suit against the company and/or its officers. This agreement will be legally binding on me, my spouse, my heirs and my descendants. I have read and understood the Injury Waiver and General Release Form.

Name        _________________________________ Date        ______________________________

Address       ___________________      State ____________________        City____________________

Zip________________________                    Phone no_____________________________

Person to be contacted in case of emergency        ____________________________________________

Phone no   __________________________


Download Injury Release Form in Word Format

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