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Keep Flower Mound Beautiful Hold Harmless Release Form
In consideration of the privilege of volunteering with Keep Flower Mound Beautiful and recognizing that the activities related to volunteering may involve certain inherent dangers, I attest and verify that I have full knowledge of the risks involved, that I solely assume those risks, that I will, without limitation, assume and pay any medical and emergency expenses in the event of an accident, injury, illness or other incapacity, regardless of whether I have authorized such expenses. I do hereby agree to assume the risks attendant to such activity, to include but not limited to: property damage or personal injury to [myself / my child] as a result of motor vehicle accidents or collisions on either public streets or private property; property damage and/or personal injury to [myself / my child] resulting from the acts, errors, omissions or negligence of the Keep Flower Mound Beautiful, Keep Flower Mound Beautiful volunteers, third parties, [myself / my child] or other Keep Flower Mound Beautiful program participants.

Further, I, on behalf of [myself / my child], and [my / my child’s] heirs, executors, administrators and assigns, forever release and discharge any and all rights, demands, claims and causes of suit or action, known or unknown, whether arising now or in the future, that I may have against the Keep Flower Mound Beautiful, and any other participating sponsors and officers, employees and agents of such parties, for any and all injuries, including death and property damage in any manner arising or resulting from my participation in these volunteer activities. Furthermore, I state that I have carefully read this release, know the contents of the release and signed the release of my own free will.

I specifically agree to indemnify Keep Flower Mound Beautiful for any and all claims by [myself / my child], which may arise from, relate to or result from [my / my child’s] participation in the Program. I agree to indemnify the Keep Flower Mound Beautiful for property damage and/or personal injury to any of its employees and agents as a result of [my my child’s] participation in volunteer activities. I hereby waive all claims, release, indemnify, defend and hold harmless the Keep Flower Mound Beautiful, directors and officers, agents and employees, in both their private and public capacities, from any and all liability, claims, suits, demands, or causes of action which may arise from [my / my child’s] participation in these volunteer activities.

I acknowledge the danger and risk of injury from the classes/activities in which I will participate, and the contagious nature of infectious diseases, including but not limited to COVID-19, MRSA, influenza, and any mutation or variation thereof, and that I could become infected through contact with or close proximity to an individual, facility, or equipment with an infectious disease, and knowingly and voluntarily accept and assume the risk, both known and unknown, that I may be exposed to an illness, injury, and death from infectious diseases by attending or participating in the classes/activities. I understand and accept that the risk of injury, infection, or death may result from the actions, omissions, negligence, or gross negligence of myself and others, including, but not limited to, KFMB and KFMB employees, agents, and representatives, and other participants or attendees at the classes/activities

I further agree that an electronic version, including one with name typed in or facsimile copy of this document containing my signature shall be just as binding and enforceable as an original signed document
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Last Name *
First Name: *
If you are affiliated with a group please list the group name. If a scout group please also list the troop/pack #
Telephone #: *
Signature (type in your name to agree to the above) *
Date *
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PHOTO RELEASE: I, the undersigned, do hereby consent and agree that KEEP FLOWER MOUND BEAUTIFUL, have the right to take photographs of me / my child and to use these in any and all media, now or hereafter known, and exclusively for the purpose of promoting Keep Flower Mound Beautiful. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. *
Signature (type in name to agree) *
Date *
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