By submitting this form, I waive and release Pathways to Housing PA, its agents, servants, employees, insurers, successors, and assigns from any and all claims, demands, causes of action, damages or suits at law and equity of any kind, including but not limited to claims for personal injury, property damage, medical expenses, loss of services, on account of or in any way related to or growing out of my presence or involvement at the facility.
This waiver and release is intended to and does release Pathways to Housing PA from any and all liability for damages or injuries on account of or in any way related to or growing out of my negligence, the negligence of third parties and Pathways to Housing PA’s negligence. This is not intended to release Pathways to Housing PA from any liability resulting from their intentional conduct. I further covenant and agree not to institute any claims or legal action against Pathways to Housing PA for any claim.
I understand that Pathways to Housing PA is not responsible for any lost, stolen, or damaged valuables or property.
I understand that by submitting this form I have consented to be bound by its terms, including the waiver/release of any legal right I may have to sue Pathways to Housing PA for any costs they incur because a claim or legal action is brought.
I am submitting this form freely, voluntarily, and competently and am at least eighteen (18) years of age.