PARTICIPANT WAIVER AND RELEASE

For and in consideration of Londonderry Township, Dauphin County, Pennsylvania (“Township”), allowing me,
the undersigned, or a minor for whom I am legally responsible to participate in any capacity in Township
events, whether sponsored, organized or run by the Township, I, for myself, and on behalf of my spouse,
children, heirs and next of kin, and any legal and personal representatives, executors, administrators,
successors, and assigns, hereby agree to and make the following contractual representations pursuant to this
Agreement (“Agreement”):
1. I am an adult 18-years or older registering myself as a Participant in a Township event or registering my
minor child for whom I am legally empowered to execute this Agreement on the child’s behalf. I assume all
responsibility for any and all damages to or theft of personal property, or any bodily injury (including
death) that may occur to Participant and further I assume all responsibility for property damage and bodily
injury (including death) that I may cause to others, in each case arising or resulting from, incident from,
incident to, or as a consequence of, in connection to the participation in, and all events, official or
unofficial, of the Township.
2. I, for myself and my heirs, executors, and administrators, release, indemnify, hold harmless from, and
waive all claims, damages and rights of action, present or future, whether the same are known or
unknown, anticipated or unanticipated, foreseen or unforeseen, arising or resulting from, incident to or as
a consequence of participation in the event, which I may now or hereafter have against the Township, its
employees, agents, or officials, WITHOUT LIMITING THE FOREGOING IN ANY WAY, I INTEND THIS TO BE A
GENERAL WAIVER OF ANY AND ALL CLAIMS WHICH ARE IN ANY WAY RELATED TO PARTICIPATION IN THIS
EVENT. Additionally, I agree to indemnify, defend and hold harmless the Township, its employees, agents,
or officials, from and against any liability, loss, or expense (including court costs and reasonable attorneys’
fees) in connection with any claims.
3. I knowingly, willingly, and voluntarily acknowledge the inherent risks associated with the event. I
understand that participating in this event may be a hazardous activity and I attest and certify that I am
physically capable of participating in this event. The event may require physical exertion over varied
terrain and in unforeseen weather conditions. The Township cannot control the landscape over which the
event will cause me to travel. I understand that it is solely my responsibility to determine which conditions
I can safely traverse. I understand that the event will occur outside where the elements can be unpredictable and it is my responsibility to prepare accordingly.

I grant full permission to the Township to use my name, photos, video, voice, and/or likeness from my
participation in the event in any medium, including social media of any kind, advertising promotions,
publications, emails, photographs, videos or other accounts of this event or at any point going forward.

5. I understand that the aforementioned risks may be caused in whole or in part or result directly or
indirectly from the negligence of my own actions or inactions, the actions or inactions of others
participating in the event, or the negligent acts or omissions of the Township or its agents, employees, or
officials, and I hereby voluntarily and knowingly assume all such risks and responsibility for any damages,
liabilities, losses, or expenses that I incur as a result of my participation in any Township event. I also agree
to be responsible for any injury or damage caused by me at a Township event.
6. This Agreement represents the complete understanding between the parties regarding these issues and no
oral representations, statements or inducements have been made apart from this Agreement. If any
provision of this Agreement is held to be unlawful, void, or for any reason unenforceable, then that
provision shall be deemed severable from this Agreement and shall not affect the validity and
enforceability of any remaining provisions.
I HAVE CAREFULLY READ THIS DOCUMENT IN ITS ENTIRETY, UNDERSTAND ALL OF ITS TERMS AND
CONDITIONS, AND KNOW IT CONTAINS AN ASSUMPTION OF RISK, RELEASE AND WAIVER FROM LIABILITY, AS
WELL AS A HOLD HARMLESS AND INDEMNIFICATION OBLIGATIONS.
By signing below, I (as the Participant or as the Parent/Legal Guardian of the minor identified below) hereby
accept and agree to the terms and conditions of this Agreement in connection with my (or the minor’s)
participation in any Township event. If, despite this Agreement, I, or anyone on my behalf or the minor’s
behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities as the result of such claim.