TOWN OF MINNEDOSA- PARKS AND RECREATION SERVICES
RELEASE AND INDEMNIFICATION FORM
THIS FORM MUST BE READ AND SIGNED BY ALL WHO WISH TO PARTICIPATE.
Elements of Risk:
The program involves certain elements of risk and injuries may occur while participating in such activities.
Following are examples of some types of injury which may result from participating in the above:
1. Scrapes, cuts, bruises
2. Strains, sprains, pulled muscles or ligaments
3. Possible fractured or broken bones (such as arms, legs, hips).
There may also be risk of other types of injury.
There also exists the risk of damage to my personal property.
Acknowledgement:
I, the participant, or parent/legal guardian of the participant, understand and accept the above and provide the Town of Minnedosa Parks and Recreation Services with the following waiver of liability and indemnification agreement:
I, the participant, or parent/legal guardian of the participant, understand that I will be responsible for any damages to any facilities or equipment that may take place during a Town of Minnedosa recreation event.
Responsibility for Damages:
I, the participant, or parent/legal guardian of the participant, agrees to be financially responsible for any damages I cause, whether intentional or accidental to the facility or equipment and will promptly reimburse the Town of Minnedosa for the full cost of repair.
Release and Indemnification Agreement:
I, the participant, or parent/legal guardian of the participant, hereby release the Town of Minnedosa and its agents from any and all liability for any injury sustained by me, or damage caused to my belongings, regardless of how caused, resulting from my participation in the Activity-on-activity date.
I further agree to indemnify and save harmless the Town of Minnedosa and its staff and agents from any and all suits, demands, torts, and actions of any kind which may be brought against its staff or agents for which it / they may become liable by reason of injury, loss, damage or death resulting from, or occasioned to, or suffered by any person or any property, by reason of any act, neglect, or default of mine.
Acknowledgement:
I have read and agree to the above. I understand that in participating in the above activity I assume the risks associated with doing so. I further understand that there is no coverage for injury to participants provided with this activity.