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.
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.