All visitors arriving at Wild Pines Sanctuary must
enter their name (and any attending minors in their care) into this form
before entering the Wild Pines Sanctuary grounds or
facilities. By entering your name (and those of attending minors) here,
you are hereby agreeing to abide by and e-signing our visitor waiver,
below.
Please read the waiver before signing!
All repeat Wild Pines Sanctuary visitors MUST sign in each visit.
ACCIDENT WAIVER AND RELEASE OF LIABILITY
1.) I AM VOLUNTARILY PARTICIPATING IN AND HEREBY ASSUME ALL OF THE
RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH Wild Pines Sanctuary's VOLUNTEERING AND SANCTUARY VISITS,
including by way of example and not limitation, any risks that may arise from
negligence or carelessness on the part of the persons or entities being
released, from dangerous or defective equipment or property owned, maintained,
or controlled by them, or because of their possible liability without fault. I
certify that I am physically fit for this activity, and have not been advised
to not participate by a qualified medical professional. I certify that there
are no health-related reasons or problems, which preclude my participation in
this activity. I acknowledge that this Accident Waiver and Release of Liability
Form will be used by the event holders, sponsors, and organizers of the
activity in which I may participate, and that it will govern my actions and
responsibilities at said activity. In consideration of my participation in this
activity, I hereby take action for myself, my executors, administrators, heirs,
next of kin, successors, and assigns as follows:
(A) I
WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not
limited to, liability arising from the negligence or fault of the entities or
persons released, for my death, disability, personal injury, property damage,
property theft, or actions of any kind which may hereafter occur to me
including my traveling to and from this activity, THE FOLLOWING ENTITIES OR
PERSONS: Wild Pines Sanctuary and/or their directors, officers, employees,
volunteers, representatives, and agents, and the activity holders, sponsors,
and volunteers;
(B) I
INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons
mentioned in this paragraph from any and all liabilities or claims made as a
result of participation in this activity, whether caused by the negligence of
the released parties or otherwise. I acknowledge that
Wild Pines Sanctuary
and their directors, officers, volunteers, representatives,
and agents are NOT responsible for the errors, omissions, acts, or failures to
act of any party or entity conducting a specific activity on their behalf.
I
acknowledge that this activity may involve a test of a person's physical and
mental limits and carries with it the potential for death, serious injury, and
property loss. The risks include, but are not limited to, those caused by
terrain, facilities, temperature, weather, condition of participants,
equipment, vehicular traffic, lack of hydration, and actions of other people
including, but not limited to, participants, volunteers, monitors, and/or
producers of the activity. These risks are not only inherent to participants,
but are also present for volunteers.
I
hereby consent to receive medical treatment which may be deemed advisable in
the event of injury, accident, and/or illness during this activity. In such
event, I agree that I am solely responsible for any associated costs, including
but not limited to the costs of receiving such medical treatment and the cost
of any required transportation.I understand while participating in this
activity, I may be photographed. I agree to allow my photo, video, or film
likeness to be used for any purpose by the activity holders, producers,
sponsors, organizers, and assigns.
The
Accident Waiver and Release of Liability Form shall be construed broadly to
provide a release and waiver to the maximum extent permissible under applicable
law, however the Accident Waiver and Release of Liability Form shall not extend
to any claims not permitted to be released by state law
If any
term or provision of this Accident Waiver and Release of Liability is declared
void or unenforceable for any reason, such declaration shall not affect any
other term or provision of this document.
BY E-SIGNING, I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ALL OF
ITS TERMS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND IF
I SIGN, I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE
RIGHT TO SUE. I SIGN THIS DOCUMENT OF MY OWN FREE WILL.
2.) PHOTO AND VIDEO RELEASEI understand while
participating in any and all activities, I may be photographed or filmed. I agree
to allow my photo, video, or film likeness to be used for any
legitimate purpose by the activity holders, producers, sponsors,
organizers, and assigns. The Accident Waiver and Release of Liability
Form shall be construed broadly to provide a release and waiver to the
maximum extent permissible under applicable law.
I, CERTIFY THAT I
HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE
THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND
I SIGN THIS DOCUMENT OF MY OWN FREE WILL.
[Provided by The Open Sanctuary Project - OpenSanctuary.org]
