Product Liability Release

for Your State

This Product Liability Release is for use when a claim results from the use of a product. A written release will be valuable in the event there are future disagreements or misunderstandings about the claim. This form is available for immediate download.

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For Immediate Download

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Please select a state

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This Product Liability Release is designed for use when a claim results from the use of a product which creates or causes injury. This release effectively sets out the description and date of the injury and the amount paid as compensation for said injury. A written Product Liability Release is important in the event future disagreements or misunderstandings occur.

This Product Liabilty Release includes the following provisions:
  • Name of Releasor: Sets out the name of the person signing the release;
  • Identity of Releasee: Sets forth the name of the person being released from liability;
  • Compensation Paid: The amount paid to the Releasor from the Releasee to obtain the liability release;
  • Description and Date of Injury: Description of the product which caused the injury and the date the injury occurred;
  • Signature: The Releasor must sign and date the document.

Protect Yourself and Your Rights by using our professionally prepared up-to-date forms.

This attorney-prepared packet contains:
  1. General Instructions
  2. Product Liability Release
State Law Compliance: This form complies with the laws of all states
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
 
Product Liability Release
 
 

 

 
[Name of Person signing release] (the “Releasor”), in consideration of [Amount Paid by Releasee to Obtain Release from Releasor (ie. $5,000.00)] and other good and valuable consideration, the receipt and sufficiency of which is acknowledged by the Releasor, hereby releases and forever discharges [Name of Person being Released] (the “Releasee”), its employees, officers, directors, shareholders, successors and assigns of and from all actions, causes of action, damages, claims and demands whatsoever, which the Releasor had, now have or which the Releasor,  heirs, executors, administrators and assigns or any of them hereafter can, shall or may have by reason of or arising out of a claim made by Releasor resulting from the use of Releasee's product known as [Describe Releasee's Product Causing Injury] on or about [Date of Injury caused by Product].
For the same consideration, the Releasor further agrees not to make claim or take proceedings against the Releasee or any other person or entity which may claim contribution or indemnity under the provisions of any statute or otherwise.
The payment by Releasee to Releasor shall not be deemed to be an admission of liability on the part of the Releasee.
IN WITNESS WHEREOF the Releasor has executed this Release on [Date of signing release (i.e. July 31, 2002)]
 
 
 
 
Witness
 
[Name of Person Signing Release]
 
Number of Pages3
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#28964
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
 
Product Liability Release
 
 

 

 
[Name of Person signing release] (the “Releasor”), in consideration of [Amount Paid by Releasee to Obtain Release from Releasor (ie. $5,000.00)] and other good and valuable consideration, the receipt and sufficiency of which is acknowledged by the Releasor, hereby releases and forever discharges [Name of Person being Released] (the “Releasee”), its employees, officers, directors, shareholders, successors and assigns of and from all actions, causes of action, damages, claims and demands whatsoever, which the Releasor had, now have or which the Releasor,  heirs, executors, administrators and assigns or any of them hereafter can, shall or may have by reason of or arising out of a claim made by Releasor resulting from the use of Releasee's product known as [Describe Releasee's Product Causing Injury] on or about [Date of Injury caused by Product].
For the same consideration, the Releasor further agrees not to make claim or take proceedings against the Releasee or any other person or entity which may claim contribution or indemnity under the provisions of any statute or otherwise.
The payment by Releasee to Releasor shall not be deemed to be an admission of liability on the part of the Releasee.
IN WITNESS WHEREOF the Releasor has executed this Release on [Date of signing release (i.e. July 31, 2002)]
 
 
 
 
Witness
 
[Name of Person Signing Release]
 

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