Waiver Form

DEFINITION –In this agreement is in consideration of The Water Works. to enable me to become a Free Water Customer.

SAFETY ACKNOWLEDGEMENT AND ASSUMPTION OF RISKS

I am aware of the possible negative effects I may have after drinking any of the water provided by The Water Works Free Water Store.

  • Any previous or current health concerns that I may have, have been taken into consideration before signing this waiver.
  • I agree to be financially responsible for any medical costs that may occur from drinking any of the water provided by The Water Works Free Water Store.

I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGER AND HAZARDS AND DAMAGE OR LOSS RESULTING THEREFROM. HENCE, I VOLUNTARILY AGREE TO RELEASE, DISCHARGE, HOLD HARMLESS, DEFEND, AND IDEMNIFY THE WATER WORKS. AND ITS OWNERS, OFFICERS, AND EMPLOYEES FROM ANY AND ALL CLAIMS, ACTIONS OR LOSSES FOR BODILY INJURY, PROPERTY DAMAGE, WRONGFUL DEATH, LOSS OF SERVICES OR OTHERWISE WHICH MAY ARISE OUT OF MY USE OF THE WATER WORKS FREE WATER CUSTOMER PROGRAM AND I CHOOSE TO SIGN UP AND DRINK THE WATER VOLUNTARILY. I SPECIFICALLY UNDERSTAND THAT I AM RELEASING, DISCHARGING, AND WAIVING ANY CLAIMS OR ACTIONS THAT I MAY HAVE AT PRESENT TIME OR IN THE FUTURE FOR THE NEGLIGENT ACTS OR OTHER CONDUCT BY THE OWNERS, AGENTS, OFFICERS, OR EMPLOYEES OF THE WATER WORKS

       

Initial Here                                            

CONSENT: 

I CONFIRM THAT I AM OF SUFFICIENT AGE (19 YEARS+) AND IN MENTAL CAPACITY TO SIGN THIS DOCUMENT. I HAVE READ AND UNDERSTOOD THIS AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE WATER WORKS 

Who will be participating?

Adult  Adult and Children  

Signee Information

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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.