Safety Waiver and Release of Liability
The HUB NWI
*Where Art and Technology Intersect*
This waiver must be completed, signed, and submitted before using any tools, equipment, or
facilities at The HUB NWI Makerspace. Your safety is our priority, and this waiver ensures you
acknowledge the inherent risks and agree to follow our policies and procedures.
Participant Information
Name: __________________________________________
Date of Birth: ____________
Phone: __________________________________________
Email: __________________________________________
Emergency Contact Name: __________________________________________
Emergency Contact Phone: __________________________________________
Acknowledgment of Risks
I understand that using tools, machinery, and equipment in a makerspace environment involves
-- Cuts, burns, or other injuries from sharp objects, heated surfaces, or tools.
- Injuries caused by improper use of machinery or equipment.
- Exposure to hazardous materials or substances.
- Slips, trips, or falls due to clutter or materials on the floor.
- Other unforeseen risks associated with creative and technical projects.
I voluntarily assume all risks associated with my participation in activities at The HUB NWI
Makerspace.
Waiver of Liability
I hereby waive, release, and discharge The HUB NWI, its owners, staff, volunteers, and affiliates
from any and all claims, liabilities, or damages arising out of or connected to my use of the
makerspace. This includes but is not limited to:
- Personal injury
- Property damage or loss
- Any other incidents or accidents
I understand that this waiver applies even if the injury or loss results from the negligence of The
HUB NWI or its staff.
Rules and Safety Compliance
I agree to follow all rules, policies, and procedures established by The HUB NWI, including:
- Completing required training before using tools or equipment.
- Wearing appropriate personal protective equipment (PPE).
- Avoiding the use of power equipment, tools, or hazardous materials while under the influence of
alcohol, drugs, or medications.
- Reporting any unsafe conditions, accidents, or equipment malfunctions to staff immediately.
Medical Treatment Authorization
In the event of an emergency, I authorize The HUB NWI staff or representatives to provide or obtain
medical treatment on my behalf. I agree to assume all financial responsibility for any medical
expenses incurred.
Minors (if applicable)
For participants under the age of 18, a parent or legal guardian must complete and sign this form.
Minors must be supervised by an adult at all times while using the makerspace.
Name of Minor: __________________________________________
Parent/Guardian Name: __________________________________________
Parent/Guardian Phone: __________________________________________
Signature
By signing this waiver, I confirm that I have read, understood, and agree to the terms outlined
above. I acknowledge that I am voluntarily participating in activities at The HUB NWI Makerspace
and accept full responsibility for my actions.
Participant Signature: _____________________________
Date: ____________
Parent/Guardian Signature (if applicable): _____________________________
Date:____________
The HUB NWI Staff Signature: _____________________________
Date: ____________
Thank you for helping us maintain a safe and creative environment!
For questions or concerns, please contact us at maker@thehubnwi.org.