Simple Release Of Liability Form Template

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Updated – 2025 /2026


Disclaimer

The document provided is intended solely as a general example for informational purposes. It does not constitute legal advice and should not be relied upon as a substitute for consulting a qualified attorney. Variations in local laws and regulations may require adjustments to ensure compliance. Use of this template is at your own risk, and we assume no liability for any errors, omissions, or consequences arising from its use without professional review.


PDF

PDF

Word

Word

Sample

Sample

Template

Template


This is a sample template of a simple release of liability form. The wording can be adjusted as needed to suit specific circumstances and legal requirements.

Simple Release of Liability Form – Example

Parties Involved:

Releaser: Alex Johnson
Address: 789 Maple Street, Springfield, IL 62704

Releasee: Jamie Lee
Address: 1010 Oak Avenue, Springfield, IL 62704

Purpose of Release:

The Releaser agrees to release the Releasee from any liability, claims, or demands arising out of [describe activity or event], that occurred on or around _________ (date).

Acknowledgment:

Both parties acknowledge that they have read this document, understand its terms, and voluntarily accept the conditions herein.

Release of Liability:

The Releaser hereby releases, waives, and discharges the Releasee from any liability, claims, or causes of action that may arise from the activity described above, including but not limited to injury, loss, or damage to person or property.

Date: ______________________

________________________
Alex Johnson (Releaser)
________________________
Jamie Lee (Releasee)