1. Paste and copy this form onto your
computer
2. Fill it out
3. Send it back by
e-mail
or by mail to Miller's, PO Box 14254,
SLO CA, 93406
|
Miller’s Equestrian Center and Sanctuary
Miller’s Equestrian Center and Sanctuary 805-235-3834 www.millersecs.org
Volunteer Waiver, Release and Indemnity Form
For and in consideration of the opportunity to participate in the philanthropic volunteer program offered by Miller’s Equestrian Center and Sanctuary, the undersigned hereby voluntarily releases, discharges, waives and relinquishes any and all actions or causes of action for the personal injury, property damage or wrongful death occurring to it arising as a result of the activities or services which the undersigned may engage in through the volunteer opportunities offered by Miller’s Equestrian Center and Sanctuary, or any activities incidental thereto, wherever or however the same may occur and for whatever period said activities or services may continue, and the undersigned does for himself or herself, his or her heirs, agents, executors, administrators and assigns hereby release, waive, discharge and relinquish any action or causes of action, aforesaid, which may hereafter arise for it, and agrees that under no circumstances will the undersigned or her or his heirs, agents, executors, administrators present any claim for personal injury, property damage or wrongful death against Miller’s Equestrian Center and Sanctuary or any of their parents, subsidiaries, officers, agents, servants, or employees for any of said persons, or otherwise. IT IS THE INTENTION OF THE UNDERSIGNED BY THIS INSTRUMENT TO EXEMPT AND RELIEVE MILLER’S EQUESTRIAN CENTER AND SANCTUARY FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE.
The undersigned, for herself or himself, her or his heirs, agents, executors, administrators agrees that in the event that any claim for personal injury, property damage or wrongful death shall be prosecuted against Miller’s Equestrian Center and Sanctuary, the undersigned shall indemnify and save harmless the same from any and all claims or causes of action by whomever or wherever made or presented for personal injuries, property damage or wrongful death.
The undersigned agrees to allow Miller’s Equestrian Center and Sanctuary, and sponsors of its events to use his or her name, voice, photo, and likeness for promotional purposes without any cash considerations or payments.
The undersigned acknowledges that she or he has read the foregoing and is fully aware of the legal consequences of signing this instrument.
Today's Date
First Name
Last Name
Mailing Address
City
State
Zip Code
Contact Phone Number
Contact Email
Please Sign Your Name
Signature of Guardian if Under 18
Please return this completed form to:
Miller’s Equestrian Center and Sanctuary PO Box 14254, SLO, CA 93406 805-235-3834 downsrs@sbcglobal.net www.millersecs.org |