OF LIABILITY, WAIVER OF CLAIMS,
ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
Please note that
by signing this agreement, you give up the right to sue for any injury
or damages, howsoever caused.
To: Broadleaf Stock
Farm Ltd. (Operating As Broadleaf Guest Ranch) ("the Company")
and its directors, officers, employees, representatives and agents (collectively
called "The Agents").
I, __________________________ hereby sign this agreement on behalf of
myself, my personal representatives, heirs and assigns.
1. I agree as a
precondition to my participation in all events organized by "the
Company" and/or "the Agents" including, but not limited
to: athletic/sports program, horseback riding, sleigh/wagon rides,
canoeing, swimming, rock climbing, obstacle course, biking, related
events and activities (collectively referred to as "the Activities")
and in further consideration of "the Company" allowing me
to do so, that I will be strictly by the terms of this Release of Liability,
Waiver of Claims, Assumption of Risk and Indemnity Agreement ("the
2. I acknowledge that "the Activities" involve inherent
risks and dangers that may cause serious injury and possible death to
3. I fully understand the risks and dangers associated with my participation
in "the Activities" and accept same entirely at my own
4. I hereby waive any and all claims which I may have against
"the Company" and "the Agents" and release "the
Company" and "the Agents" from all liability for
injury, death, property damage or any other loss sustained by me as
a result of my participation in "the Activities", due to
any cause whatsoever, including negligence, breach of contract, or breach
of any statutory or other duty of care by "the Company"
and/or "the Agents".
5. I appreciate that "the Agreement" limits the liability
of "the Agents" to the same extent as it limits the liability
of "the Company", even though "the Agents" are not
formal parties to "the Agreement".
I AM 19 YEARS
OF AGE OF OLDER, AND I HAVE READ AND UNDERSTAND "THE AGREEMENT".
I UNDERSTAND THAT THIS DOCUMENT CONTIANS A PROMISE NOT TO SUE "THE
COMPANY" AND/OR "THE AGENTS" AND THAT IT CONSITIUTES A
RELEASE OF LIABILITY AND AN INDEMNTIY FOR ALL CLAIMS.
Signature of Participant
Witness signature & name
IF I AM THE PARENT
AND/OR GUARDIAN OF THE PARTICIPANT, I HAVE READ AND UNDERSTAND AND AGREE
TO EXCUTE "THE AGREEMENT" ON BEHALF OF CHILD/WARD. I HEREBY
AGREE TO INDEMMNIFY AND SAVE HARMLESS THE COMPANY AND AGENTS FOR ANY AND
ALL CLAIMS, BY OR ON BEHALF OF OUR SAID CHILD IN RESPECT OF, OR ARISING
OUT OF, ANY NEGLIGENCE, BREACH OF CONTRACT, BREACH OF STATUTORY DUTY OF
CARE AS IT RELATES TO ALL EVENTS ORGANIZED BY "THE COMPANY"
AND/OR "THE AGENTS".
Name of Child
Signature of parent/guardian