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LIVING TREASURES SAFARI RESORT, LLC D/B/A  KEYSTONE SAFARI ROPES COURSE

WAIVER, RELEASE, AGREEMENT NOT TO SUE AND ACKNOWLEDGMENT OF RISK

This Waiver, Release, Agreement Not to Sue, and Acknowledgement of Risk (hereinafter the “Waiver”) is between LIVING TREASURERS SAFARI RESORT, LLC, d/b/a KEYSTONE SAFARI  and their owners, officers, directors, partners, members, operators, management companies, agents, servants, and employees (hereinafter collectively referred to as “Keystone Safari”) and the PATRON, PARENT, GUARDIAN OR ACCOMPANYING ADULT identified on the signature line below.

RELEASE AND AGREEMENT NOT TO SUE

IN CONSIDERATION OF BEING ALLOWED TO USE KEYSTONE SAFARI FACILITIES, I AGREE THAT I WILL NOT SUE KEYSTONE SAFARI AND WILL RELEASE KEYSTONE SAFARI FROM ANY AND ALL LIABILITY IF I, OR THE MINOR CHILD ON WHOSE BEHALF I AM SIGNING, ARE INJURED WHILE USING KEYSTONE SAFARI FACILITIES OR WHILE PRESENT ON KEYSTONE SAFARI’S PROPERTY, EVEN IF I CONTEND THAT SUCH INJURIES ARE THE RESULT OF NEGLIGENCE, INCLUDING GROSS NEGLIGENCE, OR ANY OTHER IMPROPER CONDUCT FOR WHICH A RELEASE IS NOT CONTRARY TO PUBLIC POLICY, ON THE PART OF KEYSTONE SAFARI. I FURTHER AGREE THAT I WILL INDEMNIFY AND HOLD HARMLESS KEYSTONE SAFARI FROM ANY LOSS, LIABILITY, DAMAGE OR COST OF ANY KIND THAT MAY OCCUR AS THE RESULT OF ANY INJURY TO MYSELF, OR FOR ANY MINOR CHILD ON WHOSE BEHALF I AM SIGNING, EVEN IF IT IS CONTENDED THAT ANY SUCH INJURY WAS CAUSED BY THE NEGLIGENCE, INCLUDING GROSS NEGLIGENCE, OR ANY OTHER IMPROPER CONDUCT FOR WHICH A RELEASE IS NOT CONTRARY TO PUBLIC POLICY, ON THE PART OF KEYSTONE SAFARI.

ACKNOWLEDGEMENT OF RISK

I, in consideration of permission to use Keystone Safari’s facilities, voluntarily assume the risk of injury or even death while participating in recreational activities at Keystone Safari. I agree and understand that the activities, including the use of Keystone Safari’s facilities, are inherently dangerous and further recognize any responsibility to inspect the facilities and read and obey all signs, rules, presentations, oral instructions, and regulations associated with the activities at Keystone Safari. There are inherent risks in the participation in or on any amusement ride, device, attractions, and other recreational activities (hereinafter “Amusement Activities”). These risks include, but are not limited to, the risk of self-inflicted injury, the risk of injury cause by other participants, the risk of injury as a result of slipping on or striking surrounding Amusement Activity elements, which contain wood, fiberglass, metal, and/or other hard objects, the risk of injury as a result of equipment failure and/or malfunction, the risk of injury by failure to pay close attention during Amusement Activities, and the risk of injury sustained through your own negligence and/or the negligence of others including other patrons, and the employees, agents, independent contractors or representatives of Keystone Safari, including but not limited to any operator error. The injuries that I may sustain through participation in Amusement Activities include injuries to hands, fingers, feet, and toes, including but not limited to, inflammation and/or strains of muscles, ligaments and/or tendons, nerve damage or compression and broken bones, re-aggravation of any underlying physical condition, damage that may result in loss of limbs, and finally, I understand that the description of these risk and potential injuries is not complete in that unknown or unanticipated risks may result in injury, illness, and/or death.

Patrons of Amusement Activities, through their participation or use, or the participation or use of a minor child on whose behalf they are signing, accept all risks identified above and those inherent to such Amusement Activities of which the ordinary prudent person is or should be aware. I have a duty to exercise good judgment and act in a responsible manner while using, participating in, or observing amusement activities and to obey all oral, video, and written instructions and warnings, prior to and/or during such use or participation. I have a duty to refrain from participating in or on any amusement activity when under the influence of drugs or alcohol. Further, I have a duty to properly use all Amusement Activity safety equipment.

WAIVER OF LEGAL RIGHTS

KEYSTONE SAFARI IS ASKING YOU TO GIVE UP LEGAL RIGHTS IN ORDER TO UTILIZE IT’S FACILITIES. Keystone Safari is asking you to give up certain valuable legal rights. You, any minor child you are signing for, your personal representative, and your heirs hereby agree to release, waive, discharge, hold harmless, defend and indemnify Keystone Safari and its owners, agents, officers, and employees from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, or any other claims which you otherwise may have arising out of your participation in the amusement activities at Keystone Safari. You specifically understand that you are releasing, discharging, and waiving any claim or action you may have, in the present or future, for the negligent acts or conduct by the owners, agents, servants, or employees of Keystone Safari or any of the designers or manufacturers of the zip line course. You are specifically giving up your rights to sue Keystone Safari in a court of law, your right to a trial by jury, the right to claim money damages from Keystone Safari if you are injured, the right to claim money damages from Keystone Safari if you are injured by another person, and the right to recover any damages, or punish, or make an example of Keystone Safari.

Notwithstanding the foregoing, if you choose to sue Keystone Safari, you agree that this Waiver is governed by the laws of the Commonwealth of Pennsylvania and that the venue for suit instituted hereunder shall be the Court of Common Pleas of Mercer County or the United States District Court for the Western District of Pennsylvania.

I have read and understood the above Waiver, Release, Agreement Not to Sue, and Acknowledgement of Risks and am voluntarily signing below, manually or electronically, with the intent to be legally bound by this Contract with the Consent of my spouse (if any) and understand that I may be giving up the rights of the minor child on whose behalf I am singing and spouse to sue as well as giving up my own rights to sue. I further agree that if any part of this Waiver is found to be unenforceable, all other parts shall be given full force and effect.

Date: June 24, 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 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*

Confirm Email*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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 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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