Loading...



Price’s Rentals

6 Lakeview Acres

Johnson Lake, NE 68937

(402) 690-1418

LIABILITY RELEASE CONTRACT




LIABILITY RELEASE CONTRACT


For the event on the _____ day of ___________________, 20___, being legally bound hereby, the undersigned agrees to represent the group (defined as all other occupants) and will inform each individual within the group he/she is representing, of this binding contract that binds each individual within the group with Price’s Rentals.  This release is for but not limited to; all liability for personal injuries (including death) and property losses or damage occasioned by, or about any activity.  The undersigned further agrees that he/she and every member of the group he/she is representing will abide by all the rules and regulations set forth by Price’s Rentals including but not limited to posted signs, verbal commands by the representative of Price’s Rentals, any binding contracts between the group via representative of the group, and laws set forth by the State of Nebraska. Shall Price’s Rentals be fined for offenses committed by members of the group; the representative of the group shall be held fully accountable assuming all costs associated with the incident via payment to Price’s Rentals within 14 days of the issue of the fine to pay the State of Nebraska for the offense. The representative of the group also assumes and agrees to pay all costs Price’s Rentals may incur including those related to damages and theft to be paid within 14 days of the rental period at the discretion of Price’s Rentals for the total cost incurred but Price’s Rentals will provide sufficient evidence to substantiate the reasonable claims. The representative of the group and everyone can inspect the possessions and property of Price’s Rentals related to the event before the event starts to ensure that damages were not present and all items (regarding theft) were present before the event starting. The representative of the group hereby gives Price’s Rentals permission to charge the credit card on file, for payment of all mentioned costs that Price’s Rentals may incur (after occurrence) which have been explained above. 


Signature Date Signed

 September 29, 2023

Representative of the group (print name):



First Customer's Name

First Name*

Last Name*
First Customer's Date of Birth*
I certify that I am 18 years of age or older
First Customer's Signature*
Second Customer's Name

First Name*

Last Name*
Second Customer's Date of Birth*
Third Customer's Name

First Name*

Last Name*
Third Customer's Date of Birth*
Fourth Customer's Name

First Name*

Last Name*
Fourth Customer's Date of Birth*
Fifth Customer's Name

First Name*

Last Name*
Fifth Customer's Date of Birth*
Sixth Customer's Name

First Name*

Last Name*
Sixth Customer's Date of Birth*
Seventh Customer's Name

First Name*

Last Name*
Seventh Customer's Date of Birth*
Eighth Customer's Name

First Name*

Last Name*
Eighth Customer's Date of Birth*
Ninth Customer's Name

First Name*

Last Name*
Ninth Customer's Date of Birth*
Tenth Customer's Name

First Name*

Last Name*
Tenth Customer's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!