CATSKILL/DELAWARE UV PLANT VISITOR RELEASE FORM I understand that as a visitor to the CATSKILL/DELAWARE UV PLANT, I will abide by the instructions and directions of the Plant Chief or his/her designee conducting the tour. In consideration of touring the CATSKILL/DELAWARE UV PLANT on Tuesday, April 22, during a trip with the Water Research Foundation, and use of the CATSKILL/DELAWARE UV PLANT facilities (including, but not limited to, the surrounding land, parking areas, and City facilities) hereby RELEASE AND FULLY DISCHARGE the City of New York and the NYC Department of Environmental Protection (the “City & DEP”), its agents, and employees from any liability resulting from any personal injury to myself, including wrongful death, or damage to my property, except to the extent such personal injury, wrongful death, or damage to my property is caused by the gross negligence or willful misconduct of the City & DEP or its agents or employees. I accept full responsibility for any injuries or damages which may result from the participation in the tour and I hereby hold harmless the City & DEP, its agents and employees, for any injury sustained by me, including death, while participating in the tour. I agree not to bring any action or suit against the City & DEP, its agents, and employees for any injury or damage. In signing this form, I acknowledge that I have read and understand the terms of the foregoing, and that I am waiving certain legal rights, including the right to sue the City & DEP, its agents and employees, on the basis of any claims from which I have released them herein. Visitor’s Name (Print): ______________________________ Visitor’s Signature: ________________________________ Dated: ___________________, 2014