Loading...

VOLUNTARY RELEASE, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT

The undersigned requests and is granted permission to hunt within land leased, owned or used by Jorgensen Land & Cattle Partnership.

 

I understand and accept that participating and/or observing in any type of hunting, skeet shooting, or target practice or otherwise operating firearms, or participating in any way with shooting, handling and/or carrying firearms, knives or other weapons on land leased, owned or used by Jorgensen Land & Cattle Partnership is dangerous.  I am aware that other hunters will be carrying firearms in my vicinity posing a further danger to me.   Specifically, shot discharged from shotguns presents a clear and obvious danger that may cause loss of eyesight, loss of limb, paralysis, death and other ailments, illness and/or injuries.

 

I further understand and accept that hunting, walking, riding in vehicles or trailers or otherwise moving about land leased, owned or used by Jorgensen Land & Cattle Partnership will require climbing, stooping, bending, jumping or other physical activity, and may involve traversing plowed or cultivated fields, hills, ditches, ravines, gullies, fallen trees, fences or creeks, as well as getting in or out of vehicles, both on and off road.  I further understand and accept that these activities may cause shortness of breath, physical stress, fatigue, broken bones, sprains, strains, cuts, dental and other bodily injury, including heart attack, death, paralysis, illness or other ailments and/or injuries.

 

I further understand and accept that participating and/or observing any type of hunting on land leased, owned or used by Jorgensen Land & Cattle Partnership poses certain natural dangers.  The terrain poses hidden dangers and obvious danger of which I acknowledge.  I also understand and accept that there are animals on land leased, owned or used by Jorgensen Land & Cattle Partnership that pose additional dangers.  I understand and accept that I may come in contact with animals including but not limited to the following: farm animals and livestock, deer, antelope, ticks, poisonous and nonpoisonous snakes, spiders, hunting dogs and wild dogs, insects, birds, rodents, coyotes, and other wild animals.  I further understand and accept that I may come in contact with thorns, briars, nails, other sharp objects, barbed wire, crops, plant life, potentially hazardous farm implements, as well as holes in the ground and other obstructions or hazards which may or may not be easily seen.  I further understand that I may receive or contract injury, infection and/or disease and that I may die as a result of contact with such animals, objects, hazards or potential dangers present while hunting at Jorgensen Land & Cattle Partnership

I acknowledge the contagious nature of COVID-19 and its attendant health risks. I acknowledge that Jorgensen Land & Cattle Partnership and any employee or agent thereof cannot guarantee I will not become infected with COVID-19. I understand that the risk of being exposed or infected may result from the actions or omissions of me, lodge staff, guides, and other clients. With this knowledge and understanding, I wish to participate and assume all risk of COVID-19 exposure and/or infection.

I certify that any alcohol that I bring, or hat is provided to me while, will be consumed responsibly and that no one under the age of 21 will consume any alcohol

In consideration of being able to hunt or visit the Jorgensen Land & Cattle Partnership premises including but not limited to riding in any vehicles, trailers, entering any structures, improvements, and land owned, leased or used by Jorgensen Land & Cattle Partnership, on behalf of myself, my personal representatives, heirs, next of kin, successors in interest, spouse and assigns, I hereby:

 

1.         RELEASE, DISCHARGE AND COVENANT NOT TO SUE Jorgensen Land & Cattle Partnership, its partners, managers, employees, any person or entity leasing to or allowing the use of real estate to Jorgensen Land & Cattle Partnership or the undersigned, and, their directors, officers, partners, managers, members, shareholders and employees (all hereinafter collectively referred to as "releasees") from any and all claims and liability arising out of strict liability or the ordinary negligence of the releasees or any other participants which causes me personal injury, death, damages, or property damage while hunting, shooting, observing, visiting, or any other activity set forth in the preceding paragraphs, or otherwise moving about the premises of Jorgensen Land & Cattle Partnership.  I hereby covenant to hold releasees harmless and indemnify releasees for any actions, suits and claims, judgments, demands, costs and attorneys’ fees or expense releasees may incur arising out of my hunting activities with Jorgensen Land & Cattle Partnership.

 

2.         UNDERSTAND that my entry onto land, structures, improvements, vehicles, and trailers leased, owned or used by Jorgensen Land & Cattle Partnership for the purpose of  participating in hunting or observing hunting contains the possibility of DANGER AND RISK OF INJURY OR DEATH, that hunting involves the use of firearms by myself and/or other persons, creating a hazard, danger, and risk of injury or death which I understand and I voluntarily choose to participate in the activities at Jorgensen Land & Cattle Partnership in spite of the named risks and other unnamed risks which are inherent in these activities.   I VOLUNTARILY ELECT TO ACCEPT ALL RISKS CONNECTED WITH MY ENTRY ONTO LAND, STRUCTURES, IMPROVEMENTS, VEHICLES, AND TRAILERS OWNED, LEASED, OR USED BY Jorgensen Land & Cattle Partnership AND MY PARTICIPATION IN HUNTING OR OBSERVATION OF HUNTING.

 

3.         ACKNOWLEDGE that I am aware of the rules pertaining to hunting safety and will comply with each such rule.  Acknowledge that I am responsible for my own equipment, including any dogs used in hunting.  If I have failed to comply with any rule of hunting safety, I assume all risk for myself and assume all liability for injury to others caused by such  failure, and hereby release releasees for any failure in inspecting either myself, my vehicle, or my firearm.  I am not an agent, servant or employee of releasees.  No oral representations or inducements have been made to me in order to obtain my signature on this Agreement.  If any portion of this Agreement is held invalid, it is agreed by me that the balance thereof shall continue in full legal force and effect.

 

4.         ACKNOWLEDGE that there is no guaranty made to me of the success, quantity or quality of game that may result from hunting excursions promoted, managed, guided or provided by Jorgensen Land & Cattle Partnership.

 

5.         AGREE that this Agreement shall apply to any incident, injury, accident or death  occurring while I am hunting or visiting the premises of Jorgensen Land & Cattle Partnership, on the below date and for any hunts or visits for a period of one year after the execution of this agreement.

 

6.         AGREE that this release is given on my own behalf and shall be binding upon me, my heirs, assigns and legal representatives of myself and my estate.

 

7.         CERTIFY that any alcohol that I bring, or that is provided to me, will be consumed responsibly and that no one under the age of 21 will consume any alcohol.

 

I HAVE CAREFULLY READ AND UNDERSTAND THIS RELEASE, WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Dated: December 22, 2024

First Guest Name

First Name*

Last Name*

Phone*
First Guest Date of Birth*
First Guest Information

Group Name
First Guest Signature*
Second Guest Name

First Name*

Last Name*
Second Guest Date of Birth*
Second Guest Information

Group Name
Third Guest Name

First Name*

Last Name*
Third Guest Date of Birth*
Third Guest Information

Group Name
Fourth Guest Name

First Name*

Last Name*
Fourth Guest Date of Birth*
Fourth Guest Information

Group Name
Fifth Guest Name

First Name*

Last Name*
Fifth Guest Date of Birth*
Fifth Guest Information

Group Name
Sixth Guest Name

First Name*

Last Name*
Sixth Guest Date of Birth*
Sixth Guest Information

Group Name
Seventh Guest Name

First Name*

Last Name*
Seventh Guest Date of Birth*
Seventh Guest Information

Group Name
Eighth Guest Name

First Name*

Last Name*
Eighth Guest Date of Birth*
Eighth Guest Information

Group Name
Ninth Guest Name

First Name*

Last Name*
Ninth Guest Date of Birth*
Ninth Guest Information

Group Name
Tenth Guest Name

First Name*

Last Name*
Tenth Guest Date of Birth*
Tenth Guest Information

Group Name
Guest Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

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 or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Last 4 SSN

Please enter the last 4 of your SSN (for hunting license purchase)
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 Date of Birth*
Parent or Guardian's Information

Group Name
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!