In consideration of being allowed to participate in any way in the Empty Vessel Project and related events and activities, including boarding the Empty Vessel Project boat, the undersigned, for him/herself, his/her personal representatives, heirs, next of kin:

1. Acknowledges and fully understands that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses to person or property which might result not only from his/her own actions, inactions or negligence, but also the actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.

2. Assumes all the foregoing risks and accepts personal responsibility for any and all loss, liability, damages or costs following such injury, permanent disability or death.

3. Releases, waives, discharges and covenants not to sue the Empty Vessel Project, its members, the respective administrators, directors, agents, and other employees or agents of the organization, other participants, sponsoring agencies, sponsors, advertisers, and owners/lessors of premises used to conduct any event, all of which are hereinafter referred to as "releasees," from any and all claims, liability, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or part by the negligence of the releasee or otherwise.

4. Agrees to indemnify and save and hold harmless the releasees from any loss, liability, damage, or cost they may incur due to the presence of the undersigned in any way competing, officiating, observing, or working for, or for any purpose participating in any event.

THE UNDERSIGNED HAS READ THE ABOVE WAIVER, INDEMNIFICATION AND RELEASE, UNDERSTANDS THAT HE/SHE HAS GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGNS IT VOLUNTARILY.

Printed Name ____________________________________ Date ____________________________________ Signature ____________________________________ Address ____________________________________ City ____________________________________ State: ____________________________________ Zip: ____________________________________ Phone ____________________________________ Fax

-- PaulaZ - 20 Oct 2005
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