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PARENTAL CONSENT, RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT MUST BE SIGNED BY BOTH PARENTS, IF AVAILABLE, OR THE LEGAL GUARDIAN OF ANY MINOR ENTERING UPON THE PREMISES

For and in consideration of my entry upon and use of the premises leased to Rausch Creek Off-Road Park, LLC ("hereinafter ARC4X4"), by Rausch Creek Off-Road Park Land, LLC, (hereinafter ARCOPL@) and Rausch Creek Industrial Park, LLC, (hereinafter “RCIP”); the premises so leased being hereinafter identified as the APremises@, intending to be legally bound, do hereby covenant and agree as follows:

 

1. I/We certify that I am/we are the parent(s)/legal guardian of (hereinafter individually or collectively identified as the “minor”) and acknowledge that the Premises consist in large part of land that is mountainous in topography and that has been extensively logged over, strip mined, deep mined, and that the Premises contain many other hazards which may include but not be limited to roadways, highways, rail lines, streams, and abandoned strip mines and mine workings. I/we acknowledge the risks inherent in such hazards and further acknowledge the risks inherent in the operation of 4x4 vehicles, minibuggies, and other off-road vehicles on or about the Premises.    

 2. I/we acknowledge and fully understand that the minor for whom I/we execute this document may engage only in off-roading and related activities upon the Premises and that such activities involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from the minor=s own acts, omissions, or negligence but from the acts, omissions, or negligence of others, and further acknowledge that there may be other risks not known to me or reasonably foreseeable at this time. 

3. I/we assume ALL of the foregoing risks, and all other risks, whether known or unknown, that may be present in the minor’s entry upon and use of the Premises and areas appurtenant thereto, and accept personal responsibility for the damages or injuries the minor may sustain to his or her person or property while upon the Premises, including permanent disability or death. 

 4. I/we hereby agree, for myself/ourselves and for my/our heirs, executors, administrators, representatives, successors, and assigns, to release, waive, discharge, indemnify and hold harmless RC4X4, RCIP, and RCOPL, and Rausch Creek Off-Road Park, LLC, Rausch Creek OffRoad Park Holdings, LLC, Rausch Creek Off-Road Park Land, LLC, Rausch Creek Land, LP, RCMS Investments, LP, Rausch Creek Industrial Park, LLC, Rausch Creek Development, LLC, Rausch Creek Coal Mining, LLC, Rausch Creek Gas, LP, B & L Offroad Development, LLC, and Rausch Creek Powersports, LLC, and their officers, directors, limited and general partners, agents, employees, successors and assigns, from any and all claims, suits, demands, obligations, actions, causes of action, rights or damages, litigation expenses, attorney’s fees, costs and expenses, including but not limited to claims for personal injury, permanent disability, death or property damage arising from or in any way related to the minor=s entry upon and use of the Premises or areas appurtenant thereto.  

I/WE HAVE READ AND UNDERSTAND THE FOREGOING FULLY AND COMPLETELY INDICATE THE SAME BY MY/OUR SIGNATURES BELOW AND BY MY/OUR INITIALS NEXT TO EACH PARAGRAPH ABOVE.

 September 28, 2021

 

 

Youth who are joining you in an Off Road Consulting event at Rausch Creek Off Road Park
Minor(s)
1 Minor2 Minors3 Minors4 Minors5 MinorsMore Minors6 Minors7 Minors8 Minors9 Minors10 Minors
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First Participant's youth Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's youth Date of Birth*
First Participant's youth Signature*
Second Participant's youth Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

Confirm Email*
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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