Pioneer Day Committee of Lafayette County Florida

ALL VEHICLES MUST BE OUT OF THE PARK BY 8:30AM DURING THE FESTIVAL.

Please include contact numbers as any applications not fully completed will not be processed.

The Pioneer Day Committee sponsor of the Pioneer Day Festival does not provide liability insurance for the protection of spectators, merchants, or others involved in similar activities who participate in the Pioneer Day Festival.

In consideration of participating in such activity, the participant does hereby release and forever discharge the Pioneer Day Committee, it officers, officials and members, jointly and severally, from any and all actions, causes of actions, claims and demands for upon or by reason of any damages, loss or injury, which hereafter may be sustained by participants, merchants, spectators or others in consequence of participating in the Pioneer Day Festival activities.

This release extends and applies to, and also covers and includes all unknown, unforeseen unanticipated and unsuspected injuries, damages and loss and liability and the consequences thereof, as well as those now disclosed and known to exist at the time, to the person executing such leases, are hereby expressly waived.

I hereby agree on behalf of my heirs, executor, administrators and assigns to indemnify the Pioneer Day Committee, and all members and officials of the Pioneer Day Committee, jointly and severally, and hold harmless from and against any and all action, including attorney fees, which may at any time be incurred by reason of my participation in any Pioneer Day Festival activity.

It is further agreed and understood that said allowance of my participation in the pioneer Day Festival is not to be constructed as an admission of any liability and acceptance of assumption of responsibility by the Pioneer Day Committee; it's officers and member, jointly or severally.  Festival participant shall indemnify the Pioneer Day Committee it's officers and members, jointly and severally, for all damages and expenses become liable as a result of any alleged act of the festival participant.

Date:______________________            

_____________________________________________________

Name of Participant (printed)

_____________________________________________________

Signature of Participant

___________________________________________________

If a minor, parent of guardian of minor.

For additional participants, please reproduce this form.

 116 SW Monroe Ave. Mayo, FL 32066 *(386) 294-2705* www.lafayettecountychamber.com