WAIVER OF LIABILITY AND ASSUMPTION OR RISK AGREEMENT

            In consideration of the privilege of allowing myself to participate in Officers’ Wives’ Club aboard Camp Lejeune, and further recognizing the voluntary nature of my participation, I, the undersigned person, intending to be legally bound, hereby promise to waive for myself, my guardians, heirs, executors, administrators, legal representatives and any other persons on my behalf, any rights and claims for damages, demands, and other actions whatsoever, including those attributable to simple negligence, which I may have against any or the following persons of entities: the United States of America; the Department of Defense; the Department of the Navy; the United States Marine Corps; Marine Corps Base, Camp Lejeune, North Carolina; any and all individuals assigned to or employed by the United States, the Department of Defense, including but not limited to the Secretary of the Defense, the Secretary of the Navy; the Commandant of the Marine Corps; the Commander, U.S. Marine Forces, Atlantic; the Commanding General, II Marine Expeditionary Force; the Commanding General, 2d Marine Division; the Commanding General, 2d Force Service Support Group; and the Commanding General, Marine Corps Base, Camp Lejeune, North Carolina; in both their official and personal capacities, and entities’ representatives, successors and assigns; which said injuries arise out of my participation in such activities. 

            I EXPRESSLY, KNOWINGLY, AND VOLUNTARILY ASSUME THE RISKS ASSOCIATED WITH SUCH ACTIVITIES FOR MYSELF, and agree to hold the United States and the aforementioned partied harmless for any resulting injury.  I understand that this assumption of risk agreement shall remain in effect until notice of cancellation is received by the Commanding General, Marine Corps Base, Camp Lejeune, North Carolina.  I understand that, should I decline to execute this agreement, I will not be permitted to participate in these activities.

_____________________                                                      _______________________ 
(Signature of Witness)                                                   (Signature of Participant)

Date: ________________                                                       _______________________

                                                                                                (Name of Participant)