Volunteers and participants taking part in activities on City of Hartsville property can use this form before participating. This form is also available as a downloadable PDF.

Volunteer/Participant Release and Waiver of Liability
This Volunteer/Participant Release and Waiver of Liability executed on the date shown above releases the City of Hartsville and each of its own agents and employees from all responsibility and liability as pertaining to any event held on property designated as City Property. A Volunteer/Participant is any person or organization that provides services or attends and participates in event held on property designated as City Property. By signing this form, the undersigned understands that the scope of their relationship with the City of Hartsville is limited to a volunteer/participant position and as such, will be responsible for their own insurance coverage in the event of personal injury or illness as a result of the volunteer/participant’s services to the City of Hartsville or participation in the event.

  1. Assumption of Risk: The undersigned understands that they are solely responsible for their safety. The services provided by the undersigned may include activities that deemed hazardous, including the potential for permanent paralysis and death. As a volunteer/participant, the undersigned expressly assumes risk of injury or harm from these activities, even if arising from the negligence of others, and hereby Releases the City of Hartsville and its agents and employees from all liability.
  2. Waiver and Release: In exchange for the privilege of engaging in any inherently dangerous activity of participating in this event, the undersigned hereby Releases the City of Hartsville and its agents and employees from any liability that may arise from the volunteer/participant’s presence at this facility and/or participation in the events. The undersigned understands and acknowledges that this Release discharges the City of Hartsville and its agents and employees from any liability or claim in respect to bodily injury, personal injury, illness, death, or property damage that may result from providing services, utilizing equipment, observing or participating in the event, or being present on the City property.
  3. Customary Terms and Conditions for Participation: If any unusual hazard is observed during the presence or participation of the volunteer/participant, the undersigned will remove themselves from participation and bring such information to the immediate attention of the nearest City Official.
  4. Photographic Release: The undersigned grants and conveys to the City of Hartsville and its agents and employees all right, title, and interests in any and all photographs, images, video, or audio recordings of them or their likeness or voice made by the City of Hartsville and its agents and employees in connection with the undersigned providing volunteer services to the City of Hartsville.
  5. Indemnity and Hold Harmless: The undersigned, for themselves and on behalf of their heirs, assigns, personal representatives, and next of kin, hereby, to the maximum extent permitted by law, assume entire responsibility and liability and shall defend, indemnify, and hold harmless the City of Hartsville, including its governing bodies such as Authorities, Boards and Commissions, consultants, agents, sponsors, employees, volunteers, and owners of the premises used to conduct this activity and event with respect to any and all injuries and from all claims, demands, liabilities, losses, costs, arising out of any activity on this premises, whether arising from the negligence of the releases or personal conduct or otherwise.

I HAVE READ THIS VOLUNTEER/PARTICIPANT RELEASE AND WAIVER OF LIABILITY. By signing below, the undersigned (or parent/guardian with legal authority if under 18) expresses their understanding and intent to enter into this Volunteer/Participant Release and Waiver of Liability willingly and voluntarily. The undersigned signs freely and voluntarily.

This field is applicable if you are a parent or legal guardian signing this form on behalf of a participant that is a minor (less than 18 years of age).
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