Terms and Conditions


I hereby assume all the risks of participating and/or volunteering in Special Fundraising Events hosted by the Friends Foundation of Ste. Genevieve County Memorial Hospital. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them or because of their possible liability without fault.

I certify that I am physically capable of volunteering/physically fit, have sufficiently trained to be a participant in events and have not been advised otherwise by a qualified medical person. I acknowledge that this Accident Waiver and Release of Liability form will be used by event holders, sponsors and organizers, in which I may volunteer/participate and that it wil govern my  actions and responsibilities at said event. In consideration of my participation/volunteering for the event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) Waive, Release and discharge Ste. Genevieve County Memorial Hospital, their Foundation Board, Governing Board of Trustees, leadership team, employees, volunteers, event sponsors, event volunteers, and event participants from any and all liability for my death, disability, personal injury, property damage, property theft, lost income, or any other losses, costs or actions of any kind.

(B) Indemnify and hold harmless the entities or persons mentioned above from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event.

(C) I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and or illness during this event.

(D) I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video or film to be used for any legitimate purpose by the event holders, sponsors and organizers.


IMPORTANT: Ste. Genevieve County Memorial Hospital and the organizers of this event do not provide insurance coverage for injuries that occur at this event. The costs related to those injuries are the responsibility of the individual participant.

I understand that I assume responsibility for the mechanical soundness of equipment, its parts, including, but not limited to tires, gears, chain and bolts. I have examined or will examine the equipment and certify that it is properly assembled and fit to ride. I accept responsibility for damaged or lost equipment. I hereby certify that I have read this document; and, I understand its content.


Signature: __________________________________________


Parent/Guardian Signature: ____________________________

(Parent or Guardian must also sign if under 18 years old)



For more information about these terms and conditions contact skoeller@sgcmh.org