Loading...

WAIVER, RELEASE AND INDEMNIFICATION AGREEMENT

In consideration of being allowed to attend and participate in personal/professional coaching, consultation, seminars, and workshops with Linda Bruce and Soulful Prairie, LLC and their animals, employees, agents, assistants, independent contractors, co-sponsors, volunteers, and affiliates located at 4706 Alden Road, Woodstock, McHenry County, Illinois, I hereby agree to RELEASE, WAIVE, DISCHARGE and HOLD HARMLESS,, Robert and Linda Bruce, RLB Farms, L.L.C., Soulful Prairies, LLC, their animals, agents, employees, assistants, volunteers, independent contractors, co-sponsors, and affiliates, of any liability whatsoever related to my attendance at and participation in the personal/professional coaching, consultation, coaching session, seminar or workshop or to learn their trainingmethods. Iexecutethisreleasewiththeexpressintentionofeffectingthelegalconsequences, that is, the release of all liability associated with participating in the Soulful Prairies, LLC activities and events as set forth above provided under Illinois law, including, but not limited to the release of ​Robert and Linda Bruce, RLB Farms, L.L.C.and Soulful Prairies, LLC and their animals, employees, agents, assistants, independent contractors, co-sponsors, volunteers, and affiliates for any and all liability associated with my attendance at and participation in these activities.

This WAIVER, RELEASE AND INDEMNIFICATION AGREEMENT (“Release”) shall constitute the full and complete understanding between the parties and shall supersede any prior or contemporaneous representations or agreements, oral or written. This Release is irrevocable and shall be interpreted pursuant to and governed by the laws of the State of Illinois. It is agreed that the venue for any such action at law or equity is McHenry County, Illinois. No assignment of this Release is permitted and any attempt to assign all or any rights, obligations or duties granted under this Release shall be null and void.

Consistent herewith, I hereby forever RELEASE and INDEMNIFY, and FOREVER DISCHARGE, Robert and Linda Bruce RLB Farms, L.L.C. and Soulful Prairies, LLC​, their animals, agents, employees, assistants, independent contractors and co-sponsors and affiliates, of any liability whatsoever, whether known or unknown at the time of signing, related to my attendance at and participation in the aforementioned activities on this or any other day.

I hereby take this action for myself, my executors, administrators, heirs, next of kin, successors and assigns.

I acknowledge that I have been given the opportunity to ask questions regarding any aspect of the Release contained herein, and by signing below, do acknowledge that I have carefully and completely read and fully understand all aspects of the Release and agree to these terms in their entirety. I hereby agree that should any legal proceeding arise relating to this Release and agreement, the disallowance of any term or condition will not prevent the legal enforcement of all other terms and conditions of said Release and agreement. Having been so apprised, I hereby elect to and do assume all of the risk for claims heretofore or hereafter arising, whether known or unknown, from my participation.

I hereby give my consent and permission for Soulful Prairies, LLC to take and use my picture, name and likeness for any lawful purpose, including but not limited to display on Soulful Prairies’ website, advertising, marketing and press releases. Soulful Prairies is not required to identify me, contact me nor compensate me for this use.

Today's Date: November 14, 2019

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Age: *
First Participant's Signature*
Second Participant's Name

First Name*

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

Age: *
Third Participant's Name

First Name*

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

Age: *
Fourth Participant's Name

First Name*

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

Age: *
Fifth Participant's Name

First Name*

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

Age: *
Sixth Participant's Name

First Name*

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

Age: *
Seventh Participant's Name

First Name*

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

Age: *
Eighth Participant's Name

First Name*

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

Age: *
Ninth Participant's Name

First Name*

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

Age: *
Tenth Participant's Name

First Name*

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

Age: *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive event updates and news on future programs
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.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Age: *
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