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2025 Pumpout Waiver

Dear Valued Camper,

Thank you for choosing Sleepy Hollow Lake’s Pump-Out Service!

Before we can complete your service, we kindly ask that you review and sign the following waiver:

By requesting and paying for a pump-out service, you acknowledge and agree to the following:

  • A pump-out consists of emptying the black water waste tanks from your RV or camper and disposing of the waste in a proper, sanitary manner.
  • We do not rinse or backflush tanks. This service is limited to a single pump-out only.
  • We will not pump any tanks with broken valves or any equipment we deem unsafe to operate.
  • While our trained team will perform the service with care, you assume full responsibility for any damages, leaks, spills, or equipment failures that may occur during or after the pump-out.
  • You voluntarily sign this agreement and waive any and all claims against Sleepy Hollow Lake, its owners, management, and staff.
  • You agree to indemnify and hold harmless Sleepy Hollow Lake from any liability, claims, damages, or expenses related to this service.

By signing below, you confirm that you have read, understand, and accept the terms of this waiver.

Thank you for your trust in us and for being part of the Sleepy Hollow Lake family!

Please initial each line and sign at the bottom:

I understand a pump-out includes emptying the black water tank only.


   May 31, 2025   

I understand no tank rinsing or backflushing will be performed.


     May 31, 2025  

I understand broken valves or unsafe equipment will not be pumped.


     May 31, 2025  

I accept full responsibility for any damages, leaks, or spills that may occur.


     May 31, 2025  

I voluntarily sign this waiver and release Sleepy Hollow Lake from any liability.


     May 31, 2025  

I agree to indemnify and hold harmless Sleepy Hollow Lake, its owners, and staff.


     May 31, 2025  

Please select who will be participating...
AdultMinor
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Campsite Number
Campsite Number *
First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Parent or Guardian's Email Address
Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Primary Site Holder's Driver's License
Driver's License *
  
Valid file types: JPG, GIF, PNG, and PDF
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
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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