Fillable Printable Waiver of Homeowner's Liability Form

Waiver of Homeowner's Liability Form

WAIVER OF LIABILITY - HOMEOWNER

In c ons ider a tion of par ticipa t ion in the city’s snow shoveling program, I acknowledge a nd

under sta nd that I do so a t my own risk and I voluntar ily enter into this Waiver of Liabilit y. I understa nd

tha t my participation crea tes no contr a ctual agreement with t he city of Sa lem b eyond this Waiver of

Liability, a nd tha t my a greement is bet ween the snow shoveler a nd mys elf, wit hout any involvement in

any mann er by t he Cit y of Salem.

I hereby releas e the city, it s offi c er s, employees, a gents a nd serva nts fr om a ny liability f or a ny

action or inaction by the s now shoveler that ma y result in per sonal injur y to me, or to any person enter ing

upon my property, a nd I will indemnify and save har mless the city, its officer s, employees, a gents a nd

serva nts fr om any lia bility resulting from any lega l action I institute or a ny lega l action taken against me,

for a ny per sonal injury resulting from the removal of snow or fa ilure to r emove s now by a part icipant in

this progra m. It is furt her understood and agr eed t hat this is a complete Waiver of Liability, that there a r e

no other writt en or oral under sta ndings or a greements, directly or indirectly, connected with this Waiver

of Liability, a nd that this Waiver of Lia bility contains the entir e a greement between t he under signed a nd

the City of Salem. This Wa iver of Liability sha ll be construed that whenever a pplicable, the use of a

si ng ul ar number shall inc l ude th e plural number an d the u se of th e plural number shall include the

singular number a nd shall be b inding upon and inur e to the benefit of the succ ess ors, assigns,

repr es entatives and legal representatives of the under signed a nd the City of Salem.

I H E REB Y DECLARE TH AT I HAVE HAD THE O PPORT UNIT Y TO DISCUSS THIS

WAIVE R OF LIAB ILIT Y WITH AN ATTORNEY, AND I UNDERSTAND, ACCE PT, APPROVE

AND ADOPT ALL OF THE TE RMS OF THI S WAI VE R O F LIABI LITY.

IN WIT NESS WHEREOF , and intending to b e lega lly bou nd her eb y, the undersigned has set his

ha nd and seal as of this __ da y of ____________ 2006.

_______________________________ ________________________________

PROPERTY OWNER'S SIGNATURE PRINTED NAME

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PROPERTY ADDRESS TELEPHONE NUMBER