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LizardBear Club Trip

Application & Liability Release Form

THIS IS A WAIVER AND RELEASE OF LIABILITY.


PLEASE READ CAREFULLY.

As a participant in the LizardBear Club Incentive Trip, I hereby confirm my voluntary


participation in the Palawanderland Incentive Trip.

I realize that inherent dangers exist. While in good health and able to fully participate in such
activities, I realize my participation may result in illness or injury due to accidents, the forces of
nature, or other causes unforeseen. By participating, I knowingly assume all risks of harm or
loss which may result from these activities. I hereby release, waive, discharge, and agree to
save and hold harmless TaskUs, its officers, employees, representatives or assigns, and the
LizardBear Club organizers from any and all actions, damages, demands and any further
liability whatsoever which may result from my participation in the activities, regardless of
whether or not these arise from negligent acts or omissions by the LizardBear Club organizers,
leaders or facilitators of the activity, employees or volunteers, another participant, any other
person involved or from any other cause.

I HAVE READ THE ABOVE WAIVER AND RELEASE. I UNDERSTAND THAT I HAVE
RELINQUISHED SUBSTANTIAL RIGHTS BY SIGNING IT AND DO SO VOLUNTARILY.
Printed Name: MARK GRAHAM MACAPAGAL
Signature:
Date:

Please immediately inform the organizers (before confirming your attendance) if you: 1) are
pregnant; 2) suspect you are pregnant; 3) have physical disabilities; and/or 4) have
health-related issues. A medical certificate and/or exclusion from some activities may be
required.
NAME SIGNATURE DATE
NAME SIGNATURE DATE

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