Saturday, April 15, 2023, 9am-12pm - Sussex Place, Berwyn - Site Captain Radha Pyati

CLEANUP WAIVER/SIGNUP SHEET  2023

I, the undersigned, in consideration for receiving permission to participate in the Darby Creek Cleanup and to enter the premises, waterways and grounds supervised or in any way controlled by the organization and the receipt of said permission being hereby acknowledged, do hereby forever RELEASE any and all liability, discharge and agree not to sue the Darby Creek Valley Association, their agents, members, partners, trustees, representatives, officers, sponsors, licensors, servants, volunteers and employees . I agree to hold and save them HARMLESS and indemnify them from and against any and all liabilities, claims, injuries, losses, damages, expenses, demands, actions and course of action whatsoever kind of nature arising out of or related to any such loss, damage, or injuries including death that may be sustained by me for whatever reason while participating in or upon the grounds supervised or controlled by the Darby Creek Valley Association, whether such damages are the result of negligence or for any other reason or cause. I also agree to and discharge forthwith on request of the Darby Creek Valley Association and its respective agents, members, trustees, representatives, officers, sponsors, licensors, servants, volunteers and employees and their authorized representatives, each and every obligation or claim which will be made, assigned or apportioned against the Darby Creek Valley Association and its respective agents, member, trustees, representatives, officers, sponsors, licensors, servants volunteers, and employees by any party by virtue of any injury or damage caused to me.

I am duly aware of the risks and hazards in the area of the Darby Creek Cleanup, including the risk of snake bite, animal bite, poison ivy, insect bite, broken limbs, equipment injury, drowning, and other dangers. I expressly assume the risk of my participation and acknowledge that I am responsible for my own safety and the safety of children in my care. 

In signing the Waiver, I acknowledge and represent that I have read and understand this release and agree to it voluntarily. I further understand that I am specifically waiving certain rights by this release to which I may have otherwise been entitled. I attest that I am 18 years of age and of sound mind. If I am under 18 years of age, have parent register add child/children's name in comment area. I also agree to allow pictures to be used.

In consideration for my participation in the, I acknowledge I will hold the Darby Creek Valley Association and its volunteers harmless in the event of personal injury.