Free Printable Employee Liability Waiver Template
PRINTABLE EMPLOYEE LIABILITY WAIVER
[Your Company Name]
Date: June 1, 2055
Employee Name: Malcolm Raynor
Position: Machine Operator
Department: Manufacturing
I. Acknowledgment of Risk
By signing this waiver, I, Malcolm Raynor, acknowledge that my job at [Your Company Name] may involve high-risk activities. These risks may arise from, but are not limited to:
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Use of heavy machinery and tools
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Handling and exposure to hazardous materials
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Physical exertion, lifting, or repetitive tasks
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Working in environments with potential for injury, such as construction sites, manufacturing facilities, or laboratories
I understand that these activities may carry inherent risks of accidents, injuries, or other adverse outcomes.
II. Assumption of Responsibility
I agree to assume full responsibility for any risks, known or unknown, associated with my role. I commit to following all company safety protocols, including but not limited to:
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Wearing required personal protective equipment (PPE)
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Adhering to company safety procedures and training guidelines
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Reporting any unsafe conditions or incidents to my supervisor or safety officer immediately
III. Waiver of Liability
In consideration of my employment with [Your Company Name], I agree to release, waive, and discharge [Your Company Name], its officers, employees, and agents from any liability related to personal injuries, property damage, or accidents arising from:
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My use of or exposure to machinery and tools
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Contact with hazardous materials
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Any work-related tasks that involve physical exertion or hazardous environments
Exceptions: This waiver does not apply in cases where [Your Company Name] demonstrates gross negligence or willful misconduct.
IV. Medical Fitness and Disclosure
I confirm that I am physically and mentally fit for the duties required in my role. If I have any medical conditions that could be affected by my job tasks, I will notify [Your Company Name] in writing and seek appropriate medical guidance before performing such tasks.
V. Indemnification
I agree to indemnify and hold harmless [Your Company Name] from any claims, damages, or legal costs arising from my failure to follow safety protocols or comply with company policies related to high-risk activities.
VI. Signature and Agreement
By signing below, I acknowledge that I have read, understood, and agreed to the terms of this liability waiver. I understand that this waiver is binding for the duration of my employment with [Your Company Name] in any high-risk position.
Malcolm Raynor
Date: June 1, 2055
Lyda Fadel
HR Manager
[Your Company Name]
Date: June 1, 2055