Fill and Sign the Release Personal Injury Form

Release, Waiver of Liability, Assumption of all Risks of Bodily Injury and Damage, and Indemnity Agreement Regarding Use of Owner’s Snow Plough Truck Agreement made on the _____ day of __________________, 20_____, between ________________________________ (Name of Truck Owner) of ________________________ _______________________________________________________________________________ (street address, city, county, state, zip code) , referred to herein as Owner , and _________________________________ (Name of Person Borrowing Truck) , of ____________ _______________________________________________________________________________ ________________ (street address, city, county, state, zip code) , referred to herein as Bailee . Whereas, the Owner owns the following described Snow Plough Truck located at _______ _______________________________________________________________________________ _____________________ (street address, city, county, state, zip code) , hereinafter called Truck :  Make ___________________  Model __________________  Year ______________  Color _____________  Engine Size (Cubic Centimeters) ___________________  Engine Serial Number: __________________________________  Vehicle Identification Number: ____________________________ ; and Whereas, Bailee desires to use Truck from time to time in order to clear a private road to which Bailee has access; Now, therefore, for and in consideration of being allowed to use said Truck in said manner from time to time, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned Bailee does hereby release Owner , Owner’s heirs, successors, and assigns (collectively Releasees) from all liability for property damages and/or for any physical injury or death that results, directly or indirectly from the use (accidental or otherwise) of Truck by Bailee in said road clearing operations or otherwise. Bailee further agrees to indemnify, save and hold Releasees harmless from any loss, liability, attorneys ’ fees, damage, or costs that Releasees (or any of them) may incur arising out of or related to the use by Bailee of said Truck , whether caused by the negligence of the Releasees or otherwise. This Agreement shall be governed by the laws of the State of _________________. Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. WITNESS our signatures as of the day and date first above stated. _______________________________ _______________________________ (Name of Person Borrowing Truck) (Name of Truck Owner)