Raisin' Cane Tour Guest Registration Form
VIP Tour for For the Love of Learning Private School
Event Date: Tuesday, November 12, 2019
Departure Time: 7:30 AM, please arrive by 7:15 AM
Pick Up Location: Stuart Congregational Church, 3110 SE Aster Lane, Stuart, FL 34994
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First and Last Name *
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Title *
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Phone Number *
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Mailing Address (Address City, State Zip) *
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Emergency Contact (Name, Phone Number, Contact) *
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Medical Conditions/Allergies (If none, write N/A) *
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Dietary Restrictions/Food Allergies (If none, write N/A) *
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2019 USSC Liability Form
I, the above named Visitor being 18 years of age or older, or the Parent/Legal Guardian of the above named Visitor who is under age 18, in consideration of UNITED STATES SUGAR CORPORATION, together with its affiliates and subsidiaries and its and their directors, officers, owners, employees, agents, representatives (collectively "U.S. Sugar"), and vendors and subcontractors of U.S. Sugar, and entities and individuals facilitating activities occurring throughout tour (collectively “Others”) allowing and facilitating the Visitor’s tour ("Tour"), including, but not limited to, U.S. Sugar's manufacturing facilities and properties, transportation, and any other premise or establishment that may be visited (collectively, "Property"), hereby acknowledge, agree, promise and covenant with U.S. Sugar on behalf of myself, my heirs, my assigns, my dependents, my personal representatives, and my estate as follows:

1. Acceptance of Risk and Responsibility. I understand the Tour and Property bear certain known and unanticipated risks that could result in injury, illness, or death to myself damage to my property, or injury to other parties. I voluntarily agree to accept and assume all responsibilities and risk for injury, illness, or death to myself, damage to my property or injury to other parties arising from the Tour and Property.

2. Release, Indemnification and Hold Harmless. I freely and voluntarily release and forever discharge and covenant not to sue or exercise any legal right to seek damages from or against U.S. Sugar or Others from or for any injury, illness, or death to myself, to my property, or other third parties, whenever, wherever, or however they may occur, which are related to, arise out of, are incidental to, or are in anyway connected with the Tour or Property. I agree to indemnify and hold U.S.Sugar and Others harmless from any and all claims, causes of action, liabilities, losses, expenses, costs, and amounts paid in settlement or judgment, directly or indirectly related to, arising out of, incidental to, or in any way connected to the Tour and Property, which I may negligently or intentionally cause.

3. Acknowledgement of Effect of this Agreement. I fully recognize that if I am hurt or fatally injured, or property is damaged while I am engaged in, or as a result of my participation in, the Tour or on Property, I will have no right to make any claim or file any suit against U.S. Sugar. I knowingly and voluntarily give up certain rights and claims which I might otherwise assert or maintain against U.S. Sugar and Others and assume all responsibility and legal liability for the claims which may be asserted or maintained by U.S. Sugar, Others and/or third parties against me as a result of my participation in the Tour and visitor of the Property. This Agreement shall be and is a complete bar to any legal action against U.S. Sugar or Others by me or on my behalf arising out of the Tour and Property visits, and in the event ,any such action is instituted by me or on my behalf, this Agreement shall be a complete bar to any recovery in such action.

4. Company Rules and Regulations. I agree to comply with all guidelines, rules, and regulations established by U.S. Sugar in connection with the Tour, including, without limitation, U.S. Sugar's Tour rules, security guidelines, safety guidelines, prohibition against violence and harassment, prohibition against the possession of firearms or weapons while on the Property, and prohibition against the use, possession, or being under the influence of illegal drugs or alcoholic beverages while on the Property and any additional rules or regulations communicated during the Tour or while on the Property. I fully understand that at no time during the Tour or while on the Property are alcoholic beverages permitted to be consumed. I fully understand that if I violate U.S. Sugar rules, guidelines, prohibitions, and/or regulations, with violations being determined in the sole discretion of U.S. Sugar, I may be removed from the Tour and/or Property, and I will be responsible for my own return transportation and associated costs. I acknowledge receipt of the Tour guidelines and rules, established by U.S. Sugar.

5. Permission to Seek Emergency Medical Attention. I give consent and permission to U.S. Sugar and Others to obtain on my behalf any emergency medical attention and treatment in case of illness, injury, or accident that I may suffer and to secure such medical attention and treatment at my sole expense.

6. Promotional Release. I give consent and permission to U.S. Sugar to photograph, film, videotape, record or otherwise reproduce my image and/or voice during the Tour and to use the same for any purpose without any payment to me.

7. General Provisions. I understand and agree that: (a) these provisions are intended to be as broad and inclusive as permitted by Florida laws and if any of these provisions are held invalid, the remainder will continue in full force and effect; (b) the provisions of this Agreement shall survive the expiration of the Tour; (c) my signature below indicates that I have read this entire Agreement, fully understand the terms and provisions of this Agreement, agree to be bound by the terms and provisions of this Agreement, and that I am freely and voluntarily executing this Agreement.

By typing your name below you agree to the above liability form. (First and Last Name) *
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