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June Moon Glass Workshop Release & Indemnity Agreement

Participant information

Full legal name

Date of birth

Email

Phone

This is a Release & Indemnity Agreement for the individual above.

I agree that Delise Barker DBA JUNE MOON GLASS JMG and its respective members, instructors, students and other participants (hereinafter, the “Released Parties”) shall not be liable or responsible for injury to me (including paralysis or death) or damage to my property occurring during any June Moon Glass activities and resulting from acts or omissions occurring during the performance of the activities of the Released Parties, even where the damage or injury is caused by negligence (except willful neglect).

I understand and agree that all parties participate voluntarily and at their own risk in all JMG activities and I assume all risks of injury and damage arising out of such activities. I acknowledge and understand that the activities of stained glass, include working with sharp glass, grinders, chemicals, and tools and other potentially dangerous tools and products are inherently dangerous, and I knowingly assume all such risks which may cause serious injury or death to myself.

I release and hold the Released Parties harmless from any injury or loss to my person or property which may result from my participation in JMG activities and events.

I UNDERSTAND THAT THIS MEANS THAT I AGREE NOT TO SUE THE RELEASED PARTIES FOR ANY INJURY OR RESULTING DAMAGE TO MYSELF OR MY PROPERTY ARISING FROM, OR IN CONNECTION WITH, THE PERFORMANCE OF THEIR DUTIES IN SPONSORING, PLANNING, OR CONDUCTING STAINED GLASS.

Waiver of Rights Under State Statutes

I further agree to waive all benefits flowing from any state statute that would negate or limit the scope of this release. By signing this release, I certify that I have read this release and fully understand it and that I am not relying on any statements or representations made by the Released Parties.

I expressly agree that this Agreement is intended to be as broad and inclusive as is permitted by applicable laws, and that if any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. This Agreement contains the entire understanding of the parties relating to the subject matter, and shall not be altered, modified, amended, waived or supplemented in any manner whatsoever except by a written agreement signed by both parties hereto or their duly authorized representatives. To the maximum extent permitted by applicable law, I (a) covenant and agree not to elect a trial by jury with respect to any issue arising out of this Agreement or the Services that is triable of right by a jury, and (b) waive any right to trial by jury with respect to such issue to the extent that any such right exists now or in the future. This waiver of right to trial by jury is given knowingly and voluntarily. I have read and understood this Agreement and enter into it voluntarily in consideration of the opportunity to participate in the Services. I acknowledge I am giving up legal rights and/or remedies which may be available to me.

Emergency contact

Contact name

Contact phone

Medical information & authorization

Relevant medical conditions or allergies

Media release (optional)

Untitled checkboxes field

I grant permission for photos/videos taken during activities to be used for promotional purposes.

Risk acknowledgment

I understand and acknowledge that participation in the selected activities involves inherent risks, including but not limited to physical injury, and I voluntarily assume all such risks.