Employee Wellness Activity Waiver - EN

Employee Wellness Activity Waiver
Name*

First NameLast Name
Are you an Employee Wellness participant?*

YesNo
If yes, please provide your EIN*
This Activity Waiver & Release for Employee Wellness activities between 1st day of January to 31st day of December 2026, including, but not limited to, yoga, stretching, walking, running, hiking, participating in sports or lawn games, service projects, and team building activities.

RELEASE OF CLAIM AGAINST SALT LAKE COUNTY

By signing below I certify that the above is true, and I hereby release, indemnify and hold harmless Salt Lake County, its directors, officers, and the Salt Lake County Employee Wellness team and any or all of their affiliates or employees from and against any and all liability for any claims, demands, injuries, damages, action or causes of action, whatsoever, arising out of my participation in events held by Employee Wellness of Salt Lake County.

I acknowledge that I do not have any physical limitations, medical ailments, physical or mental disabilities that would limit or prevent me from participating in the above activities.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: