Hazelton Family Lake Anna Home WAIVER
ACKNOWLEDGMENT OF RISK
I fully recognize that there are dangers and risks to which I may be exposed by participating in a retreat or event at the Hazelton family Lake Anna home.  The following are examples of possible risks and dangers but are not limited to: fallings, slipping, crashing, colliding that may result in accidents, injuries, or any other unforeseen incidents that may occur.  I also realize that participation in an activity can result in personal injury, accident, or illness, including but not limited to insect bites, sprains, broken bones, paralysis, dismemberment, or death.  I should ask about other potential hazards and recommended precautions and procedures directly related to the activities I will be participating in.  I recognize that I am not being forced into participating in this retreat or event, but I want to do so despite the dangers and risks and despite this release and covenant not to sue.


EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY
I therefore agree to assume and take on all of the risks and responsibilities in any way associated with this activity. I HEREBY RELEASE BEKY AND DAVE HAZELTON FROM ANY AND ALL LIABILITY, CLAIMS AND ACTIONS THAT MAY ARISE FROM INJURY OR HARM TO ME, FROM MY DEATH OR FROM DAMAGE TO MY PROPERTY IN CONNECTION WITH THIS RETREAT/EVENT.  


RELEASE
I recognize that this release and covenant not to sue means I am giving up, among other things, rights to sue Beky and Dave Hazelton for injuries, damages or losses that I may incur.  I also understand that this release binds my family, heirs, executors, and assigns as well as myself.


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READ CAREFULLY BEFORE SIGNING
By signing this contract, I acknowledge my responsibility to follow the stated rules.
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If under 18, please have our parent fill out and sign the portion of the form below.
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