The best digital event waiver software company- WaiverElectronic.

Pittsburgh Region International Student Ministries

4001 Fifth Avenue,Pittsburgh, PA  15213-3545, Telephone: 412-683-0342, Website:

PRISM Release and Indemnity Agreement


I, the undersigned, in consideration of my participating in a P.R.I.S.M. Activity or event represent that:

I am 18 years of age or older.  I am submitting this release, waiver of liability, and assumption of risk declaration voluntarily and of my own free will.  I have no physical or emotional problems, nor any history thereof, which will impair my ability to participate in this event in a safe manner.                

I know that risk exists in all places, known and unknown, and in all activities conducted during the weekend and that no safety precautions taken by PRISM or anyone else can guarantee my safety. I freely accept and fully assume the risk that I can get hurt in both expected and unexpected ways even if I follow the instructions or advice of the staff, volunteers or any other persons or organizations connected with PRISM. I hereby relieve PRISM and its agents, officers, employees, volunteers and affiliates from any duty to protect me from harm, and even if they chose to implement safety procedures, that such actions shall not alter the fact that they have no duty to protect me.

I understand and agree that it is my responsibility to assess the hazards presented by my participation in this event, and further agree that I am the ultimate judge as to whether I can participate without risk of harm to myself. 

I hereby give up, waive and release any and of all my rights that I or my heirs may have to sue or make any claim against PRISM and its agents, officers, employees, volunteers and affiliates, for any injury to property or person I may suffer, whether such injury arises while I am upon the premises.  I expressly assume all the dangers that may arise incident to participating and release all claims, including but not limited to personal injury, property damage or destruction, and death, whether caused by or resulting from the negligence of the property owner or  all other persons or organizations connected with PRISM, breach of contract or otherwise.   

I hereby agree to reimburse and indemnify PRISM and its agents, officers, employees, volunteers and affiliates for all costs and damages incurred as a result of any injury that I cause or receive, whether or not caused by the active or passive negligence or other fault of a party indemnified here.

I expressly agree that the foregoing consent and release of liability is governed by the laws of the Commonwealth of Pennsylvania and is intended to be as broad and inclusive as permitted by Pennsylvania law, and that in the event any portion of this consent and release of liability and indemnification agreement is determined to be invalid, illegal, or unenforceable, the validity, legality and enforceability of the balance of this agreement shall not be affected or impaired in any way and shall continue in full legal force and effect.

I, the undersigned, have entered into this consent and release of liability and indemnification agreement freely and voluntarily (not under duress). I have read this document.  I understand that by signing it I am giving up certain legal rights including, the right to recover damages against PRISM or anyone associated with PRISM in case of damage to person, property or death.  


PRISM Photo & Video Release Form

Permission to Use Photograph and Video

SubjectPRISM Activities and Events, Academic Year 2017-2018

I grant to PRISM, its representatives, employees, staff and volunteers the right to take photographs and video of me, my child(ren) and my property in connection with the above-identified subject. I authorize PRISM, its assigns and transferees to copyright, use and publish the same in print and/or electronically.

I agree that PRISM may use such photographs and video of me with or without my name and for any lawful purpose, including, but not limited to, such purposes as publicity, illustration, advertising, social media and web content.

I have read and understand the above:

Please enter your name.
Please enter your email.
Click to sign
Please sign here.
Please enter valid date.
Click to sign
Please sign here.