STATE EMPLOYEE WAIVER DESIGN

Event Name: Annual State Employee Sports Day

Event Date: April 15, 2065

Event Location: Denver, CO 80202

Participant Name: Elvie Block

Department: Department of Health Services

Contact Information: elvie@you.mail | 222 555 7777

1. Acknowledgment of Risks

I, the undersigned participant, acknowledge that participating in state-sponsored recreational activities involves inherent risks, including but not limited to:

• Physical injury (e.g., sprains, fractures)

• Accidents (e.g., falls, collisions)

• Illness (e.g., dehydration, heat exhaustion)

• Property damage (e.g., to personal belongings)

I understand that these risks may arise from my own actions, the actions of others, or the conditions of the activity.

2. Assumption of Risk

By signing this waiver, I voluntarily assume all risks associated with my participation in the recreational activity, including but not limited to those outlined above.

3. Waiver of Liability

I hereby waive, release, and discharge the State of Colorado, its departments, employees, agents, and representatives from any and all claims, liabilities, or causes of action arising out of my participation in the recreational activity, including any claims for personal injury, property damage, or wrongful death, whether caused by negligence or otherwise.

4. Indemnification Agreement

I agree to indemnify and hold harmless the State of Colorado and its employees from any loss, liability, damage, or costs, including court costs and attorney fees, that may arise from my participation in this activity.

5. Medical Considerations

• I confirm that I am in good health and have no physical condition that would prevent my safe participation in this activity.

• In case of an emergency, I authorize Jolie Cassin, Event Coordinator, to secure medical treatment on my behalf if necessary.

6. Governing Law

This waiver shall be governed by and construed in accordance with the laws of the State of Colorado.

7. Acknowledgment of Understanding

I have read this waiver in its entirety, understand its contents, and voluntarily agree to its terms. I understand that by signing this waiver, I am giving up certain legal rights.

Signature:

Elvie Block

Participant

Date: March 1, 2065

---

Emergency Contact Information:

Name: Jolie Cassin

Phone Number: 222 555 7777

---

For Official Use Only

Received by: Clint Renner

Date: March 1, 2065

Jolie Cassin

Event Coordinator