LIABILITY WAIVER & RELEASE AGREEMENT The Community Builders, Inc. (which is an affiliate of the owner of this community) aims to provide the residents of this community with the services necessary to develop and maintain a stable, productive and self-sufficient lifestyle. In order to attract good quality program providers and service providers to the community, we request that residents provide a waiver form that will be effective in connection with any and all program or service provided to the residents. Please read and fill out the form below: On behalf of myself and any minor children listed below, I (“Participant”)hereby knowingly and voluntarily release the owner of the community in which I reside, The Community Builders, lnc. (“TCB”), and the property management agent for the owner (if different from TCB), and their respective employees, agents, partners, members, affiliates, representatives, successors, assigns from any and all liability, loss, damage, costs, claims, and/or causes of action, resulting from or arising out of Participant's participation in the programs and services offered at the Property (which includes, without limitation, any off-site programs and services offered in connection with the Property and any related transportation).Such programs and services may include (but are not limited to):a) Reinforcing my financial stability) Helping me obtain adequate and necessary health care; ) Providing assistance related to finding and/or maintaining employment; ) Providing a fitness center for residents' use and/or fitness programs) Providing my children with programs and activities; and) Addressing any action that may jeopardize compliance with my lease provisions and housing assistance. I understand that these programs and services require my active participation and will only be offered to me if I wish to participate. I understand that my information will not be used or disclosed for any purposes or to any parties unrelated to the programs or services, and only the information necessary to provide the programs and services will be shared. I understand that none of the above parties provide any health insurance coverage in connection with these program or services. In the event that I am injured or become ill during a program, I authorize the owner, the property manager or the program instructor to arrange for my transportation to the nearest emergency room for treatment. I accept responsibility for any necessary expense incurred in the medical treatment that is not covered by my own health insurance .By selecting, "Read and Understand, indicates that I am the age of 18 years or older and that my consent is freely given as a condition of participating in the programs and services provided to me. If I am the parent or legal guardian of a minor, by selecting "Read and Understand" covers all children in my household. give my permission that photographs, audiotapes, and video records of me and my child/ward (if applicable) taken by or on behalf of TCB may be used without compensation by TCB and all other associated organizations for publicity purposes. Resident/Parent/Guardian Signature *
