2021 Release/Indemnification

Release/Indemnification

Participation in Event
Name *

First Name Last Name
Email *
example@example.com
Company Name
If different than above
I. RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT: PARTICIPANT (AND PARENT(S)/LEGAL GUARDIAN(S) IF APPLICABLE) MUST READ CAREFULLY BEFORE SIGNING
In consideration for being permitted to engage in the following activities: *

Railway Festival Manassas Jazz Festival Celebrate America Bands, Brews & BBQ Fall Jubilee Holiday Market
I hereby acknowledge, represent, and agree as follows:
A. I understand that the above-described activities are or may be dangerous and do or may involve risks of injury, loss, or damage. I further acknowledge that such risks may include but not limited to bodily injury, personal injury, sickness, disease, death, and property loss or damage, arising from the following circumstances, among others:
Vendor Activity/Set-Up Description: *
Please describe vendor booth set-up and any activities being offered as part of the events selected above.
Initials: *
Participant [and parent/legal guardian if applicable] initials here)
B. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, I hereby expressly assume all such risks or injury, loss, or damage to me or to any related third party arising out of or in any way related to the above-described activities, whether or not caused by the act, omission, negligence, or other fault of City of Manassas and Historic Manassas, Inc., its officers, its employees, or by any other cause.
Initials: *
Participant [and parent/legal guardian if applicable] initials here)
C. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, I further hereby exempt, release, and discharge, City of Manassas and Historic Manassas, Inc. its officers, and its employees, from any and all claims, demands, and actions for such injury, loss, or damage, arising out of or in any way related to the above-described activities, whether or not caused by the act, omission, negligence, or other fault of City of Manassas and Historic Manassas, Inc., its officers, its employees, or by any other cause.
Initials: *
Participant [and parent/legal guardian if applicable] initials here)
D. I further agree to defend, indemnify and hold harmless City of Manassas and Historic Manassas, Inc., its officers, employees, insurers, and self-insurance pool, from and against all liability, claims, and demands, including any third party claim asserted against City of Manassas and Historic Manassas, Inc, its officers, employees, insurers, or self-insurance pool, on account of injury, loss, or damage, including without limitation claims arising from body injury, personal injury, sickness, disease, death, property loss or damage, or any other loss of any kind whatsoever, which arise out of or are in any way related to the above-described activities, whether or not caused by my act, omission, negligence, or other fault, or by the act, omission, negligence, or other fault of City of Manassas and Historic Manassas, Inc., its officers, its employees, or by any other cause.
Initials: *
Participant [and parent/legal guardian if applicable] initials here)
E. By signing this RELEASE AND INDEMNIFICATION AGREEMENT, I hereby acknowledge and agree that said AGREEMENT extends to all acts, omissions, negligence, or other fault of City of Manassas and Historic Manassas, Inc, its officers, and/or its employees, and that said AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State of Virginia. If any portion hereof is held invalid, it is further agreed that the balance shall, notwithstanding, continue in full legal force and effect.
Initials: *
Participant [and parent/legal guardian if applicable] initials here)
F. I understand and agree that this RELEASE AND INDEMNIFICATION AGREEMENT shall be governed by the laws of the State of Virginia, and that jurisdiction and venue for any suit or cause of action under this Agreement shall lie in the courts of Manassas, Virginia.
Initials: *
Participant [and parent/legal guardian if applicable] initials here)
This RELEASE AND INDEMNIFICATION AGREEMENT shall be effective as of the date set forth below and shall be binding upon me, my successors, representatives, heirs, executors, assigns, and transferees.
Initials: *
Participant [and parent/legal guardian if applicable] initials here)
II. PARTICIPANT SIGNATURE AND DATE:
Sign Here: *

Clear
Signatory Name *

First Name Last Name
Date & Time: *
III. PARENT/LEGAL GUARDIAN SIGNATURES:

(Each parent/legal guardian must complete the following if the Participant is under 18 years of age:)
A. I am/we are the parent(s)/legal guardian(s) of the Participant and by my/our signature, agree to be bound by and responsible for all of the provisions of this RELEASE AND INDEMNIFICATION AGREEMENT, on behalf of ourselves, the Participant, and the successors, representatives, heirs, executors, assigns, and transferees of ourselves and the Participant.
B. I/we consent to the Participant's execution of this RELEASE AND INDEMNIFICATION AGREEMENT and participation in the activities described in Part I.
Printed Names and Signatures of Parent(s)/Legal Guardian(s) (if applicable):
Name:

First Name Last Name
Sign Here:

Clear
Date & Time:
Name:

First Name Last Name
Sign Here:

Clear
Date & Time:
Should be Empty: