Waiver of Liability/Informed Consent
I, the undersigned, have chosen to retain the services of Bender Defenders, LLC, for purposes of driving my motor vehicle and me to my home or other designated location. I hereby affirm that a valid insurance policy exists covering this motor vehicle, including protection against property damage and personal injury. I understand that having said insurance policy is required of me as a condition of receiving the services of Bender Defenders, LLC in the future.
In consideration for the willingness of Bender Defenders, LLC to provide services to transport me and my vehicle, I, for myself, my heirs and assigns, hereby release and hold harmless the company and its agents from death, bodily injury, loss, liability, claims, demands, or causes of action that may result or as a result of such activity. I hereby assume all risks and dangers and all responsibility arising from any conduct of Company or its agents occurring during the course of its services. I further acknowledge that Company reserves the right to refuse service to me at any time and for any reason.
I hereby affirm that I have read and fully understand this release of liability, understand that I have given up substantial rights for myself, my heirs, and my property, and that by signing this release I am signing it freely and voluntarily without any inducement.
To agree to this waiver, fill in your full name below and click 'I Agree'. You will then be taken to a page where you can fill in additional information and optionally pre-register for pick-up.