Piney Town Drop Off Waiver

RELEASE, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT

In consideration of participating in camp and drop off child care activities, and for other good and valuable consideration, I hereby agree to

release and discharge from liability arising from negligence and its owners, directors, officers

employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively

referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate,

and also agree as follows:

1. I acknowledge that participating in camp activities involves known and unanticipated risks which could result

in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are

not limited to, broken bones, torn ligaments or other injuries as a result of falls or contact with other participants,;

death as a result of medical conditions resulting from physical activity; and damaged clothing or other property. I understand such risks simply

cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity.

2. I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the

negligence of the Releasees. My participation in this activity is purely voluntary and I elect to allow my child to participate despite the

risks.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all

claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use

of their equipment or facilities, arising from negligence. This release does not apply to claims arising from

intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs

to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

4. I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in

this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no

medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume –

and bear the costs of – all risks that may be created, directly or indirectly, by any such condition.

5. In the event that I file a lawsuit, I agree to do so solely in the state where Releasees’ facility is located, and I further

agree that the substantive law of that state shall apply.

6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain

in full force and effect.

By signing this document, I agree that if I am hurt or my property is damaged during my participation in this

activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties

being released on the basis of any claim for negligence.

I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to

signing. Also, I understand that this activity might not be made available to me if I were to choose not to sign this release, and agree that the opportunity to 
participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document

and I agree to be bound by its terms.

PARENT OR GUARDIAN ADDITIONAL AGREEMENT

(Must be completed for participants under the age of 18)

In consideration of (PRINT minor’s names) being permitted to participate in this

activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are brought

by or on behalf of minor or are in any way connected with such participation by minor.