Mediation, Arbitration and other Alternative Dispute Resolution Processes [ACTIVITY]

DISPUTE RESOLUTION SERVICES, LLC [PROVIDER] does not provide liability or general insurance for the protection of individuals, groups, organizations, businesses, spectators, or others who may participate in the [ACTIVITY].

In consideration for your participation in said [ACTIVITY], the individual, group, organization, business, spectator, or other, does hereby release and forever discharge the [PROVIDER], and its officers, board, and employees, jointly and severally from any and all actions, causes of actions, claims and demands for, upon or by reason of any damage, loss or injury, which hereafter may be sustained by participating in the [ACTIVITY].

This release extends and applies to, and also covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, damages, loss and liability and the consequences thereof, as well as those now disclosed and known to exist. The provisions of any state, federal, local or territorial law or state providing substance that releases shall not extend to claims, demands, injuries, or damages which are known or unsuspected to exist at this time, to the person executing such release, are hereby expressly waived.

I hereby agree on behalf of my heirs, executors, administrators, and assigns, to indemnify the [PROVIDER] and its officers, board and employees, joint and severally from any and all actions, causes of actions, claims and demands for, upon or by reason of any damage, loss or injury, which hereafter may be sustained by participating in the [ACTIVITY].

It is further understood and agreed that said participation in the [ACTIVITY] is not to be construed as an admission of any liability and acceptance of assumption of responsibility by the [PROVIDER], its officers, board, and employees, jointly and severally, for all damages and expenses for which the [PROVIDER], its officers, board and employees, become liable as a result of any alleged act of the participant(s).