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Public Event

Release Agreement for Placer Land Trust Activities

I hereby acknowledge my attendance at a Placer Land Trust (PLT) event on the private property of PLT, and/or my participation performing volunteer efforts on behalf of PLT, including but not limited to, office and special event assistance, tabling at community events, and other preserve-based efforts.

I am voluntarily participating in this PLT event at my own risk. I agree to release PLT, its employees, and representatives (including volunteers) from liability and hold PLT harmless in regard to any and all claims, liabilities, suits, or expenses (hereafter collectively ‘claim’ or 'claims'), including claims caused or alleged to be caused by the negligence of PLT (but not its gross negligence or intentional or reckless misconduct), for any injury, damage, death or other loss to me in any way connected with my participation in PLT activities, entry on PLT property, or my use of PLT equipment or facilities. This release of liability applies to my successors in interest and any assigns.

If I drive my personal vehicle on PLT property, I do so at my own risk. I agree to have a valid driver’s license in my possession, proof of insurance, and to release PLT from any liability or damage related to the use of my vehicle while on PLT property.

I agree to abide by all public health policies and stay home if I have a cough, fever, or feel unwell.

Release Agreement Signature

My signature below certifies that I understand the above agreements and that this agreement supersedes all prior agreements, understandings and representations concerning my participation in any PLT event.

November 17, 2024

Permission to Be Photographed and/or Videotaped

I grant to PLT, its representatives, and employees the right to take photographs/video of me and/or my property in connection with the PLT event or volunteer activity I am attending. I authorizePLT, its assigns, and transfers to copyright, use, and publish the same in print and/or electronically.

I agree that PLT and/or its authorized representatives may use such photographs/videos of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

I give my permission to be photographed or videotaped
First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
*By providing my email address, I authorize Placer Land Trust to communicate with me via email*
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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