APPENDIX A 

 EXAMPLE OF LIABILITY RELEASE 



Safety and Liability Statement 

 , representing 



(printed name) (agency/organization) 

 have been briefed on the safety aspects of 



my work at the Field Research Facility, Duck, North Carolina. I have also 

 read and understand the safety regulations concerning work on and around the 

 pier. 



I agree to hold the Government harmless against any claims, demands, or lia- 

 bilities arising out of the use or operation of the facility during the 



following terra of the experiment or study: to 



(date) (date) 



(signature) 



(date) 



CERC FORiM 134 

 1 August 1978 



103 



