Hold Harmless Release Form

Please print and fill out the following form when coming to the farm for the first time.

 

East West Farm Hold Harmless and Release of Liability

 

I___________________________, agree to hold East West Farm, it’s owners, tenants, affiliates and associates (i.e. “The Farm”) harmless and release them of any liability for any injury to my person or to any person in my party, whose name(s) I provide below; except in cases of severe, gross negligence or maliciousness. I agree that I will hold “The Farm” harmless and release from liability for any damage to personal property belonging to myself or someone in my party such as but not limited to; vehicle, clothing, toys, cameras, phones, etc. I understand that I, and members of my party can and will be held responsible/liable for any actions that are in any way destructive, harmful or show disregard for “The Farm”, other guests, animals, plants, crops, and structures. Such actions include but is not limited to; teasing, chasing, striking, or otherwise harassing any animal; damaging any plant material whether it be garden crops, trees, flowers, shrubs etc. by climbing, pulling, stepping, breaking, and so forth. I and/or members of my party can and may be requested to leave, and understand that any legal manner may be utilized to seek compensation or restitution for any damages incurred. Any legal costs and fees shall be at my own expense.

 

I understand that when I come onto the property known as East West Farm, I am entering an environment that is populated by a variety of animals such as, but not limited to cattle, dogs, chickens, rabbits and while these animals are domesticated, they may act unpredictably in a manner that could cause injury such as biting, kicking, pecking, pushing, etc. I understand that certain activities carry an inherent risk at I choose to engage in or indirectly take part in said activity at my own risk. These activities can include, but aren’t limited to hay rides, horse back riding, camping, cooking, handling, tools, operating power tools or machinery. I also realize that due to the existence of a variety of animals, I should expect to encounter their manures in most any area of the farm and that I will wear appropriate foot wear such as closed toe shoes or boots also for the purpose of protecting my feet from sticks, rocks, hooves, or any other object that could cause injury.

 

Lastly, I understand that East west Farm is a FAMILY farm and I will help to support an environment that is nurturing, uplifting, and encouraging.

 

 

Signed x__________________________________________Relationship to guest____________

 

Printed name of guest_____________________________________________

 

Date _______________________________________________

 

List below additional persons in your party. Any minors who are not immediate family members, must have a release form signed by a parent or legal guardian.

 

1.___________________________________________________

 

2.___________________________________________________

 

3.___________________________________________________

 

4.___________________________________________________

 

5.___________________________________________________

 

6.___________________________________________________

 

7.___________________________________________________

 

8.___________________________________________________

 

 

 

 

 

Updated January 20, 2012 by Daniel Seedorf

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: