Fill and Sign the For Burning Form

Copyright 2004 USLegalforms.com WAIVER AND RELEASE FROM LIABILITY FOR INDIVIDUAL OWNER FOR USE OF LAND FOR BURNING I, ________________________, HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge ________________________ from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I ever had or may have, arising from or in any way related to m y burning activities on the premises of land owned by ________________________ in the County of , in the State of provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct. I understand that my participation in the burn may involve sustained strenuous physical acti vity and exposure to smoke and heat. I understand that the activities in which I will partici pate are inherently dangerous and may cause serious or grievous injuries, including bodily injury, damage to personal property and/or death; that injuries can occur because of the condition of the land, and that t he land may pose such dangerous conditions due to snakes, insects, spiders, ditches, erosions, sharp rocks, culverts, fallen tre es, braches, snow, mud, or other natural and man-made hazards. I acknowledge that I do have a burn pla n and understand my role during the burn, including the actions I am to take in the event t hat the burn escapes or otherwise deviates from the behavior predicted by the plan. On behalf of myself, my heirs, a ssigns and next of kin, I waive all claims for damages, injuries and death sustained to me or m y property that I may have against the aforementioned released party to such activity. By this Waiver, I assume any risk, and take full responsibility and waive any claims of personal injury, death or damage to personal property and real property owned by ________________________ including but not limited to burning on the land, using the land in any manner, form or fashion, and e ngaging in any activities or other related burning activities on and off the premises. This WAIVER AND RELEASE contains the entire agreement between the parties, and supercedes any prior written or oral agreements between them concerning the subject matter of thi s WAIVER AND RELEASE. The provisions of this WAIVER AND RELEASE may be waived, altered, amended or repealed, in whole or in part, only upon the prior written consent of all parties. I have read, understand and fully agree to the terms of this WAIVER AND RELEASE. I underst and and confirm that by signing this WAIVER AND RELEASE I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to e xecute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. I am 18 year of age or older and mentally competent to enter into this waiver. This agre ement and its terms and provisions will include any minors who accompany me or who are under my care. I further agree tha t I shall assume responsibility for watching and caring for minor’s safety and guarding against all hazards, natural or man made, whether expressly mentioned in this WAIVER AND RELEASE or otherwise. ____________ Date ________________________ Printed Name Signature