About this Event
SOUTH FLORIDA WATER MANAGEMENT DISTRICT
Liability Release
WHEREAS,----------------------------------------------------- (herein after referred to as "PARTICIPANT") has
(Print full name)
voluntarily requested, from the South Florida Water Management District (herein after referred to as "DISTRICT"), to participate in the following described activities: Audubon Everglades Field Trip, the aforementioned activities shall commence on ,and end on This release shall extend to all activities
which may involve the use of DISTRICT property, and surrounding rights of way owned or occupied by the DISTRICT; and
WHEREAS, the DISTRICT is willing to allow use of its property, and surrounding rights of way owned or occupied by the DISTRICT to facilitate the above identified activities upon the representations and conditions that PARTICIPANT agrees to abide by all safety procedures, agrees to obey all directions and demands of DISTRICT personnel, if any, and PARTICIPANT specifically acknowledges and assumes any and all risks associated the above identified activities;
NOW THEREFORE, in consideration of the premises set forth above, I hereby release and agree to indemnify and hold harmless the DISTRICT (including, but not limited to its Governing Board members, employees, agents, attorneys, legal representatives, and their successors and assigns) from any and all liabilities, personal injuries, claims, damages, attorneys fees, costs, judgments, claims bills, etc. (under the laws of the State of Florida and/or any other State of the United States of America and/or the Government United States of America) attributable, in whole or in part, to the acts, omissions, or negligence of the PARTICIPANT, DISTRICT or any third person that arises out of, or related to the above referenced activities.
Signed and attested to this day of ,2023, by
[Signature of Participant] [Signature of Witness]
[Signature of Parent/Guardian], if under 18 Participant's
Address: [NOTE: When multiple parties are involved in the above
described activities, a separate Liability Release must be
completed for each, and filed with the DISTRICT prior to
the commencement of those activities.]
Participant's
Phone:
Home Address
Form 1154 (09/20/06/FED)
Event Venue & Nearby Stays
South Florida Water Management District, 3301 Gun Club Road, West Palm Beach, United States
USD 0.00
