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WILSTEM WILDLIFE PARK
General Waiver and Release

I, the undersigned participant (“Participant”), acknowledge that I may be involved in one or more activities, including but not limited to: riding and operating 4-wheelers, all-terrain, and other off-road vehicles; equine activities; zip-lining; hiking; swimming; playing basketball or other sports; and animal encounters, which may involve entering animal enclosures and petting, feeding, bathing, or otherwise interacting with a variety of wild animals (the “Activities”) in connection with my visit to Wilstem Wildlife Park (the “Park”).

Assumption of Risk
I do hereby affirm and acknowledge that I HAVE BEEN FULLY INFORMED OF THE SIGNIFICANT RISK INHERENT IN MY PARTICIPATION IN THE ACTIVITIES, INCLUDING PARALYSIS AND DEATH, AND KNOWINGLY AND FREELY ASSUME ALL SUCH RISK, whether known or unknown and EVEN IF ARISING FROM THE NEGLIGENCE of those persons released hereby.

Personal Responsibility
I UNDERSTAND I AM RESPONSIBLE FOR FOLLOWING SAFETY GUIDELINES AND ALL RULES. I further certify I am in good health and have no physical condition that would prevent participation in the Activities. If zip-lining, I certify I am of a minimum weight of 70lbs and a maximum weight of 250lbs. I FURTHER ACKNOWLEDGE AND AGREE THAT WILSTEM SHALL NOT BE LIABLE FOR ANY INJURY WHICH I MAY INCUR, or for any loss, theft, or damage of personal property due to my visit(s) to and participation in the Activities at the Park. In the event of injury, I CONSENT TO EMERGENCY TREATMENT AND AUTHORIZE PARK PERSONNEL TO TREAT ME as they deem medically necessary; provided, however, that I shall bear the entire cost of such treatment.

Release of Liability, Waiver of Claims, and Indemnity
I hereby waive, release, absolve, indemnify and forever hold harmless Wilstem, Inc., French Lick Ziplines, LLC, and all of their subsidiaries, related affiliates or entities, directors, shareholders, agents, volunteers, sponsors, employees, officers, contractors, subcontractors and attorneys, their respective heirs, personal representatives, successors and assigns, and all predecessors and successors in interest (collectively, “Wilstem”), from any and all claims or liability of every name and nature, known or unknown, arising out of, in connection with, or during my visit(s) to and any current or future participation in the Activities at the Park.

I HAVE READ THIS GENERAL WAIVER AND RELEASE AGREEMENT, INCLUDING THE ASSUMPTION OF RISK, PERSONAL RESPONSIBILITY, RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY PROVISIONS AND FULLY UNDERSTAND ITS TERMS, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

FOR PARENTS OR GUARDIANS OF A PARTICIPANT UNDER THE AGE OF 18: I CERTIFY THAT I, AS PARENT OR GUARDIAN WITH LEGAL RESPONSIBILITY FOR THIS PARTICIPANT, CONSENT TO HIS OR HER RELEASE AS PROVIDED ABOVE AND I RELEASE AND HOLD HARMLESS WILSTEM FROM ANY AND ALL LIABILITY INCIDENT TO MY MINOR CHILD’S PARTICIPATION IN THE ACTIVITIES AS PROVIDED ABOVE.

PARTICIPANT MAKES THE FOLLOWING STATEMENT: “I accept the above terms and assume the risk of injury or death.”

Today's Date: October 16, 2021

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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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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