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Acknowledgement of Risk and Release Form

 (Please print out and send ONE completed release form and ONE registrations form along with your deposit FOR EACH PERSON participating in this trip)

        I hereby acknowledge that I am participating in a trip to Niagara Fall, New York for the purpose of participating in a wedding, according to the laws and requirements of the State of New York.  If I am to be married, I understand that I am fully responsible to provide to the State of New York all required documents and identification papers for the marriage license application.  I also understand that I have read the requirements for marriage in the State of New York, and further, that Rev. Waun, her sponsors, their agents and employees are not liable for my failure to understand, prepare and bring with me all the identification and documentation needed for the marriage license application process. I understand that Rev. Waun is acting in good faith to perform my marriage and that she has planned this trip to the best of her ability, and that she is not responsible for unforeseen problems with the bus, hotel, license bureau or schedule on this trip.

        I understand that it is my responsibility to make appropriate hotel reservations for me and my guests. I understand that if this trip is under-registered, my trip deposit will be refunded to me by Sept. 20, 2011.  I also understand that no trip deposit is refunded in the event of my own cancellation of this reservation.

        I hereby release Rev. Renee (Maurine) C. Waun and her sponsors-the Unitarian Universalist Minister’s Association of Pittsburgh (UUMAP) and The Westmoreland LGBTQ Interfaith Network (WLIN), including its agents and employees, from all liability, in connection with any injury, illness, delays or demise I may experience on my trip. However, I understand that this release does not exonerate these sponsors, their agents and employees, from acts of negligence or intentional tort where UUMAP/WLIN had a clear duty to act, and where it can be proved that my injury, illness or demise had a direct causal link to an act of omission of an employee or agent of the sponsors. In such cases, I agree to submit my claim to binding arbitration, and I waive my right to sue in a court of law.

In case of emergency, please contact

 (name and phone number):

_____________________________________________________________

Note any dietary or medical

restrictions:_____________________________

Name (printed): _________________________________________

Signed: _________________________________________________

Date: __________________________________________________

THE DEADLINE FOR RESERVATIONS IS SATURDAY, SEPTEMBER 17

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