Hold Harmless Agreement

PRINT AND BRING WITH YOU TO REGISTRATION!

USCG AIR STATION MIAMI

MORALE, WELL-BEING, AND RECREATION

(MWR) ACTIVITIES AND FACILITY USAGE

RELEASE AND HOLD HARMLESS AGREEMENT

In consideration for being allowed to participate in the MWR program and/or utilizing MWR equipment, I hereby release and hold harmless the United States of America, the Department of Homeland Security, the United States Coast Guard (USCG), the USCG MWR Program, and all of their officers, agents, and employees, acting officially or otherwise, from any and all claims, demands, actions, or causes that may result from any liabilities or claims arising from my (and/or my guest’s) participation.  I agree that I will never prosecute, or in any way aid in prosecuting, any demand, claims or suit against the United States Government* for any loss, damage, or injury to my person or property that may occur from any cause whatsoever as a result of taking part in these activities or use of the USCG MWR equipment or facilities.

 

I also understand and agree that I may be held liable for any damage or loss to the United States Government equipment or facilities that is caused by my gross negligence, willful misconduct, or fraud.

 

 

SIGNATURE OF PARTICIPANT:                                        DATE: 

                              

____________________________________                                     __________________

 

PRINT NAME OF PARTICIPANT:

_____________________________________________________

                   

ADDRESS OF PARTICIPANT:

 ______________________________________________________

                  

                                                 ______________________________________________________

 

 

I, __________________________, parent/legal guardian of the above-said minor child (children), consent to his or her taking part in the USCG MWR support facilities and activities.  I will abide by the above.

 

SIGNATURE OF PARENT/GUARDIAN:                                          DATE

 

__________________________________________                                      _______________

 

*United States government, as used here, includes USCG MWR support activities and any officer, agent, or employee of the USCG MWR support activities, acting officially or otherwise.