SAMPLE WAIVER FORM


2005 ANNUAL MEETING AND EXPOSITION
GENERAL RELEASE AND SAVE HARMLESS WAIVER


Including Use of Alcohol and Illegal Drugs
 
The undersigned, having been fully advised as to the nature and possible dangers and hazards of:
 
Trip Number/Name/Dates go here.
(Example: GSA Field Trip #1: Paleontology and Geology of the Green River Formation, Utah and Wyoming - Tues.–Fri., Oct. 22–25)
 
Sponsored by The Geological Society of America®, does hereby assume any and all risks involved in connection with the trip, and does hereby save and hold harmless THE GEOLOGICAL SOCIETY OF AMERICA® from any and all claims, losses and damages (including attorney's fees and any costs involved because of said claims), on account of injury, death or property damage, or inconvenience or loss of money due to delay that may arise, by reason of my participation in the trip. I understand that my use of alcohol or drugs would impair my judgment and coordination, and I will hold the Society harmless from claims arising from the use of either. I understand that I am responsible for my own medical and liability insurance.
 
___________________________________
Signature of Participant 
 
___________________________________
Date 
 
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