LANGLEY ACTIVITIES ASSOCIATION

PARTICIPANT WAIVER OF RIGHTS AND CLAIMS

FOR PERSONAL INJURY AND PROPERTY DAMAGE

I am aware that the activities of the Langley Activities Association (LAA) league(s) and/or club(s) involve the possibility of bodily injury and/or property damage from risks and dangers that include, but are not limited to, physical exertion, physical contact between participants, playing conditions, the conditions of playing fields or courts, mechanical devices, and equipment used in the league(s) and/or club(s).

I understand and agree that neither NASA, NASA Langley Research Center, NASA Langley Activities Association, the Federal Government, nor their employees warrant or guarantee my safety from property damage or personal injury or harm of whatsoever kind or nature that might result from my participation in LAA league(s) and/or club(s).

AS A CONDITION TO MY PARTICIPATION IN LAA LEAGUES(S) AND/OR CLUB(S) INDICATED ON MY ELIGIBILITY CERTIFICATION, I HEREBY VOLUNTARILY, INTELLIGENTLY, AND KNOWINGLY WAIVE ANY AND ALL RIGHTS AND CLAIMS FOR DAMAGES FOR ANY PROPERTY LOSS OR PERSONAL INJURY OF WHATSOEVER NATURE OR KIND WHICH MAY HEREAFTER ACCRUE TO ME AS A RESULT OF ANY AND ALL INJURY (BODILY INJURY OR PROPERTY DAMAGE) I MIGHT SUFFER FROM MY PARTICIPATION IN LAA LEAGUE(S) AND/OR CLUB(S).

This waiver of liability shall remain in effect until such time as I am no longer eligible to participate in or am participating in LAA activities based on the employment information given above.

 _________________________________

Participant’s name (please print)

 _________________________________ _____________

Participant’s signature Date

 January 2005

Page Curator: Scott Angster (s.r.angster@larc.nasa.gov)

NASA Official Responsible For Content: LaTunia Melton (latunia.p.melton@nasa.gov)