Release Of Liability, Waiver Of Claims And Assumption Of Risks And Indemnity Agreement (Page 2 of 2) in pdf

DO WAIVE A TRIAL BY JURY IN ANY ACTION, PROCEEDING, OR COUNTERCLAIM BROUGHT BY EITHER OF THE PARTIES HERETO

AGAINST THE OTHER ARISING OUT OF THIS AGREEMENT AND THE RELATIONSHIP BETWEEN THE PARTIES.

Each provision of this Agreement shall be considered separable and if for any reason any provision or provisions in this Agreement are

determined to be invalid or contrary to any existing or future law, that invalidity shall not impair the operation of this Agreement or affect those

portions of this Agreement which are valid.

Although Howard County, MD as the owner of Savage Park is not a party to this Agreement between myself and the RELEASEES, I hereby

agree on behalf of myself, my heirs, executors and assigns to waive any and all claims, hold harmless and indemnify Howard County, MD its

officer, agents, employees, volunteers and assigns, from and against any and all claims, actions or damages whatsoever arising from my

participation in Adventure Activities unless due to the sole negligence of Howard County, MD with no negligence on the part of any other party.

By signing below I am giving Terrapin Adventures the right to take and use photos/videos taken during the days activities for use by THE

RELEASEES for promotion purposes.

I am not relying upon any oral or written representations or statements made by THE RELEASEES with respect to the safety of Adventure Activities

other than what is set forth in this Agreement. I acknowledge that THE RELEASES have not made any representations as to the safety of the

Adventure Activities.

I confirm that I have read, been fully informed, and understand this Agreement prior to signing it, and I am aware that by signing this Agreement, I

am waiving certain legal rights which I or my heirs, next of kin, executors, administrators, assigns and representatives may have against THE

RELEASEES.

For participants of a minority age, I hereby certify that I, as parent/guardian with legal responsibility for this participant of minority age, do consent

and agree, to his/her release of all THE RELEASEES, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify THE

RELEASEES from any and all liabilities incident to this participant of minority age’s participation in these Adventure Activities.

Please complete all the fields below

Weight Restriction

Participation in some activities is restricted, due to safety reasons, to persons of a certain age, weight and height. Please indicate your

Weight ______________ lbs.

Height ______________ inches

Age ________________ please indicate age in years

Date of Birth: ______/______/__________ (month/day/year)

___ I am not disclosing above information because I am just observing and not participating in anyway.

THIS IS A RELEASE OF LIABILITY.

DO NOT SIGN UNTIL YOU HAVE READ AND FULLY UNDERSTAND ITS CONTENTS. PLEASE COMPLETE ENTIRE FORM.

Date of Event: _______/_______/_________ (month/day/year)

Signature of Participant :__________________________________________________________________

Print Full Name of Participant: _____________________________________________________________

Address: ____________________________________________________________ City: ______________State: ______ Zip: ________

Telephone Number: _______________________ Email address: _________________________________________________________

(We do not sell our lists to any outside entities)

______________________________________________________

Signature of Parent/Guardian if Participant is under 18 years of age

For Office Staff Use Only

Witness Signature: ___________________________________________ Print Name of Witness: ________________________________

Terrapin Adventures at Savage Mill: 8600 Foundry Street Savage, MD 20763

301-725-1313 301-725-0445 FAX

Release Of Liability, Waiver Of Claims And Assumption Of Risks And Indemnity Agreement Page 2

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