Laserfiche WebLink
Utility Box Beautification Program <br />Downtown San Luis Obispo <br />BOX ART <br />RELEASE FROM LIABILITY <br />PERSONAL INFORMATION (PLEASE PRINT) <br />Full <br />City: <br />Emergency Contact: — <br />Special Accommodations: <br />SS #: <br />WAIVER AND LIABILITY RELEASE <br />State: Zip* <br />I have read the Artists Agreement and will adhere to the rules and regulations set forth wherein and act <br />in a respectful manner while representing the City of San Luis Obispo. I assume the responsibility of <br />mental and physical fitness to participate in the assignment, and agree to abide by all rules and <br />requirements of the program. I also understand that failure to abide by the above may lead to my <br />termination from the program. <br />-iderstand that I am not considered an employee of the City of San Luis Obispo for the purposes of <br />orkers' Compensation, but that the City provides volunteer accident insurance in excess of any other <br />medical insurance I may have. I agree to comply with the City's policy on reporting any injuries I incur <br />while under the City's supervision. <br />I agree to hold harmless the City of San Luis Obispo, its officers, employees and volunteers from and <br />against any and all liability arising out of or in any way connected with my participation in the program. <br />THIS RELEASE SHALL APPLY EVEN THOUGH LIABILITY MAY ARISE OUT OF NEGLIGENCE OR <br />CARELESSNESS ON THE PART OF THOSE DISCHARGED INCLUDING THEIR EMPLOYEES, <br />AGENTS AND VOLUNTEERS. <br />This waiver and liability release shall apply to myself, as well as any of my heirs, executors or <br />administrators. <br />I am of lawful age and legally competent to sign this agreement I understand the terms and <br />have signed this document as my own free act. <br />I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS RELEASE BY READING IT <br />BEFORE I SIGNED IT. I REALIZE THAT BY SIGNING THIS DOCUMENT I AM GIVING UP LEGAL <br />RIGHTS TO WHICH I MAY BE ENTITLED. <br />'''NATURE PRINTED NAME <br />DATE W. '41 <br />25E -29 <br />