Release And Hold Harmless Agreement Template - County Of Clackamas
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2Clackamas County Film & Media Production
RELEASE AND HOLD HARMLESS AGREEMENT
Production Company Name: ___________________________________________________________
Address: __________________________________________________________________________
Contact Name: ________________________________________ Title: ________________________
Email: ____________________________________ Phone: _____________________________
Production Title: ___________________________________________________________________
The undersigned Production Company has requested a filming permit from Clackamas County for the
limited purpose of:
□ Television □ Motion Picture/Feature □ Commercial Photography □ Music Video
□ Documentary □ Educational □ Commercial □ Other: _______________________________
The undersigned is required to provide a Release and Hold Harmless Agreement from and defend
against any and all claims, lawsuits or other liability arising from as a result of the activity, event or use
relating to the permitted activity. The undersigned acknowledges and affirms that the County has
agreed to permit such activity subject to condition and requirements outlined in the permit application
and guidelines and as follows:
Permittee shall agree to, and does hereby agree to indemnify, defend and hold harmless, the County,
its Commission, agents, officials and employees from and against any and all claims, loss, liability,
damages, costs and expenses, including, but not limited to, any and all liability for damage to property
and/or any and all liability for personal injury or death as a result of the activity, event or use provided
for in this Permit and/or as a result of participation in or attendance at the activity, event or use
provided for in the Permit, caused by the negligent acts, errors, or omissions of the Permittee, its
agents, subcontractors, or employees, or others, regardless of whether or not Permittee alleges such
claim, loss liability, damage, cost or expense, is cause or contributed to, in part, by the County.
Signature: __________________________________
Printed Name: ___________________________
Company: ___________________________________ Title: __________________________________
Dates of Filming: From: ________________________ To: ____________________________________
Time of Day: From: _____________ □ am □ pm
To: _______________ □ am □ pm
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Parent category: Legal