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Wilstem Wildlife Park operates a USDA licensed facility dedicated to inspiring education, collaboration, and conservation for wolves and indigenous, North American wildlife. In consideration of the opportunity of Wilstem allowing me to participate in the Hike with Ambassador Wolves at Wilstem, Inc. on private land in French Lick, IN, I agree, on my behalf and on behalf of my heirs, beneficiaries, legal representatives, successors and assigns, to the following:

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

Email*

Confirm Email*
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Assumption of Risks:

I am fully aware that the Ambassador Wolves are powerful animals and that I must be observant and mindful in being in their presence. I understand there are unique risks and inherent dangers associated with coming into contact with any animal. In hiking at Wilstem on private land, I understand there are risks and inherent dangers which can result in personal injury. Despite the unique risks and inherent dangers associated with coming into contact with the Ambassador Wolves or wild animals native to the Wilstem, I freely accept and fully assume any and all risks, dangers and hazards that may occur including, but not limited to, personal injury, illness, death, property damage or loss, whether caused in whole or in part by the ordinary negligence (active or passive) or conduct (intentional or unintentional). At no time will I tease any animals or disobey the instructions of the Wilstem handlers and team members. *
I Agree*
No
Yes
Promise Not to Sue:

I will not sue, or otherwise make any claims against, Wilstem, Inc., or any of its members, officers, directors, employees, agents, lessors, contractors or volunteers, for any personal injury, illness, death, property damage or loss I may sustain as a result of my participation in activities with Wilstem, Inc. and its Ambassador Animals or any of its members, officers, directors, employees, agents, lessors, contractors or volunteers. *
I Agree*
No
Yes
Release of Liability:

I fully waive, release and discharge Wilstem, Inc., and its members, officers, directors, employees, agents, lessors, contractors and volunteers, from any and all liability or claims for any personal injury, illness, death, property damage or loss which I may sustain as a result of my activities with Wilstem, Inc. and its Ambassador Wolves. I intend this release to be as broad as possible under applicable law. *
I Agree*
No
Yes
Promise to Indemnify:

I agree to indemnify, defend and hold Wilstem, Inc., it's Ambassador Animals, members, officers, directors, employees, agents, lessors, contractors and staff, harmless from and against any and all damages, claims, liabilities, demands, causes of action, judgments, settlements, losses, costs or expenses (including attorneys' fees or medical expenses) arising out of any personal injury, illness, death, property damage or loss to anyone else which occurs as a direct or indirect result of my activities or my actions or failure to act while participating in Wilstem activities. *
I Agree*
No
Yes
Consent to Medical Treatment:

I give permission to Wilstem to administer first aid and to arrange for medical care and treatment for me in case of a medical emergency. I also give permission to the health care professional to examine, diagnose and treat me, or secure treatment for me, if proper and necessary under the circumstances. A photocopy of this consent will be valid and may be accepted as the original. I acknowledge that I am solely responsible for any and all charges for medical services provided to me or on my behalf. *
I Agree*
No
Yes
Compliance with Applicable Laws:

I agree to comply with all applicable federal, state and local laws, ordinances and regulations governing the care of Wilstem, Inc.'s Ambassador Animals. I further agree to comply with all PWS rules, policies and practices. I understand if I fail to comply with the provisions of this paragraph, my hike with the Ambassador Wolves will promptly end. *
I Agree*
No
Yes
Photo Policy:

I understand that all photographs and video taken at Wilstem are for personal use only and not to be used for professional promotion, distribution or gain unless otherwise negotiated under contractual agreement. *
I Agree*
No
Yes
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(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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 I AM SIGNING THIS AGREEMENT OF MY OWN FREE WILL. BY SIGNING THIS AGREEMENT, I ACKNOWLEDGE THAT I HAVE CAREFULLY READ ITS PROVISIONS AND FULLY UNDERSTAND ITS CONTENTS. I HAVE ALSO HAD THE OPPORTUNITY TO ASK QUESTIONS CONCERNING THE DANGERS WHICH CAN BE LIFE THREATENING WHEN INVOLVED IN HIKING AND BEING AROUND THE AMBASSADOR WOLVES OF WILSTEM, INC. AS WELL AS BEING EXPOSED TO THE ELEMENTS OF THE OUTDOORS AND UNPREDICTABLE ENCOUNTERS OF WILD ANIMALS NATIVE TO WILSTEM. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND THAT I WILL BE FOREVER PREVENTED FROM SUING OR OTHERWISE MAKING ANY CLAIM AGAINST WILSTEM, INC., OR ITS MEMBERS, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, LESSORS, CONTRACTORS, STAFF, AND ITS AMBASSADOR ANIMALS WITH RESPECT TO ANY CLAIMS HEREBY RELEASED.


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