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Potomac Patuxent Chapter

PPTU Liability Release Form

Please fill out the form with the information for your specific outing and verify that your email address is correct. Then, read and indicate your acceptance of the Release of Liability and click the Submit button. You will receive a copy of your completed form via email.

PPTU Outing
Outing Participant (Your Name):
Participant's Email Address :
Release of Liability

As a participant in the listed outing conducted by the Potomac-Patuxent Chapter of Trout Unlimited (PPTU) I do hereby irrevocably and unconditionally release, quitclaim, hold harmless, and forever discharge PPTU, its officers, directors, members, and agents from any and all debts, actions, causes of actions, claims demands, damages, costs, loss of services, loss of use, loss of possession, expenses, compensation, assessment, or any other adverse claim or liability arising from, or in any way occurring or resulting in connection with, the above specified PPTU outing, and agree that this release shall include, but not be limited to, any and all costs, interest, assessments or other charges, past, present or future, in regard to this matter. I freely accept and agree to this release with the full understanding and acknowledgement that my participation in this outdoor outing may expose me to risks associated with nature, natural terrain and environments, and wildlife.

Digital Signature:

© Potomac-Patuxent Chapter of Trout Unlimited 1999-2018
P.O. Box 2865 Wheaton, MD 20915
Contact us at mail@pptu.org

This document last modified 05/25/18