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RELEASE FORM FOR IN-PERSON CLASS

Name *

First

Last

1 form per household

Todays Date *

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Agreement *

I agree to the following terms:

In consideration of being permitted to use the services provided by Hazard Plan (Hazard Plan, LLC.), I hereby release, discharge, and hold harmless Hazard Plan, its officers, directors, employees, agents, and assigns from all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, injury or other.

I understand that Hazard Plan does not assume responsibility for or liability for any damage, personal property, injury, or recommendations made throughout the process now or any time in the future.

I understand that it is my responsibility to accept or deny any recommendations offered by Hazard Plan. I acknowledge that this release of liability shall be binding upon my heirs, assigns and immediate family members.

I have read this release of liability, fully understand its terms, understand that I have given up substantial rights by signing it and sign it freely and voluntarily without any inducement.

I also agree not to share any course content, handouts, forms or other information contained within the course(s) with anyone outside of my immediate household. Sharing this information is considered theft and will be prosecuted accordingly.