Corporate Carpool Waiver and Release

This Carpool Waiver and Release (“Agreement”) is entered into by the individual named below (“Participant”) in connection with voluntary participation in the company carpool program (“Program”).

Assumption of Risk

Participant acknowledges that participating in the Program may involve certain risks, including, but not limited to, vehicular accidents, property damage, bodily injury, and other unforeseen hazards.

Release of Liability

In consideration for being permitted to participate, Participant hereby releases and holds harmless the company, its officers, employees, and agents from any claims, actions, or losses arising from participation in the Program.

Insurance Disclosure

Participant understands that personal or driver automobile insurance may be applicable in case of accidents, and verifies responsibility for such coverage.

Medical Emergencies

Participant authorizes necessary medical treatment in case of emergency and agrees to bear any resulting costs.

Participant Information

Signature

Date