The Pied Connection Hunting Preserve
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Liability Waiver
RICHARD’S WHITETAIL HUNTING PRESERVE
WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF THE RISK ASSOCIATED
TO BE COMPLETED AND SIGNED BY EVERY PARTICIPANT
In consideration of my participation in activities arranged for me by Richard’s Whitetail Hunting Preserve, I hereby release and covenant not to sue Richard’s Whitetail Hunting preserve or its Owners, Employees, Representatives, Agents and Lessees from any and all present and future claims resulting from ordinary negligence and inherent risk of my participation , in my activities or arrangements, the use of the facilities and equipment of Richard’s Whitetail Hunting Preserve, including, but not limited to any loss, injury, damage or liability, by me, while on or about the premises of the Preserve.
I am fully aware and understand that Richard’s Whitetail Hunting Preserve, does not have, employ or contract with any medical services, provisions for ordinary or emergency medical services, including emergency cardiovascular assistance.
I agree that prior to participating in any activity arranged for me by Richard’s Whitetail Hunting Preserve, I will inspect equipment to be used and if any defects noted or I am not knowledgeable in the proper use of any of the equipment or services, I will obtain proper instructions for correct usage of such equipment or the facility.
I further agree to indemnify and hold harmless Richard’s Whitetail Hunting Preserve its Owners, Employees, Representatives, Agents and Lessees from any and all claims arising from my involvement or receiving instructions for activities incidental, whenever and however the claims may arise , including but not limited to travel to and from the activity site and / or participation at remote sites.
I assume all the forgoing risks and accept personal responsibility for any damage and losses of property, injury, permanent disability or death resulting therefrom.
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Indicates required field
Participant's Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Participant's Age
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Less than 13
13-18
19-25
26-35
36-50
Over 50
Phone Number
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I elect not to wear a helmet if being transported on any ATV
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I will wear a helmet
I do not wish to wear a helmet
I HAVE READ AND FULLY UNDERSTAND THE ABOVE WAIVER, RELEASE AND ASSUMPTION OF RISK. BY TYPING MY NAME IN THE BOX BELOW, I UNDERSTAND AND VOLUNTARILY SIGN THAT I HAVE WAIVED SUBSTANTIAL RIGHTS, RELEASE AND ASSUMPTION OF RISK.
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TYPE OUT FULL PARTICIPANT'S NAME IN THE BOX BELOW.
ANY PERSONS UNDER THE AGE OF 18 YEARS OF AGE MUST HAVE A PARENT OR LEGAL GUARDIAN CO-SIGN THIS FORM. IF APPLICABLE, TYPE PARENT OR LEGAL GUARDIAN'S FULL NAME IN THE BOX BELOW.
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TYPE PARENT OR LEGAL GUARDIAN NAME IN THE BOX BELOW.
SUBMIT
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