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I, the undersigned(s) and those listed below, agree to the following Waiver, Releases, and Compliance at Honesdale/Pocono KOA Holiday (Hereby HP KOA) at 50 Countryside Lane, Honesdale, PA 18431. I understand that I am of the age to sign and am freely signing this Waiver.

I understand the risk of injury that exists while participating in CAMPING and All Activities/Amenities on this campground (hereinafter the ‘Camping’); and in consideration of my desire to participate is said Camping participate in same;

In consideration of Honesdale/Pocono KOA, renting me any RV Site, Tent Site, Cabin (deluxe), Amenities, Equipment, Usage, I specifically release and forever discharge HPKOA and its officers, agents, and employees from all liability during Camping or claims for injury, illness, death, or loss of reputation or damage to property, which I may suffer while renting/participating said RV Site/Tent Site/ Cabin (deluxe), campground/amenity/equipment/usage. This discharge specifically includes, but is not limited to, liability or claims for injury, illness, and death or damaged, including but not limited to, COVID-19 or any other disease/sickness. It is my intent by the Waiver and Release Agreement to release HPKOA and hold harmless from all liability for any such property loss or damage, personal injury, or loss of life, negative reputation on USurveyed posting/listing of my (family) name, whether caused by negligence of HPKOA or my breach of campground rules and/or whether based upon breach of contract, breach of warranty, or any other legal theory. I understand that I am giving HPKOA the right to use my name on the USurveyed.com website for me and my family/friends behavior while at the property of HPKOA during the above dates.

 - I understand that I will not participate in any camping if I am under the influence of drugs or alcohol

 - I agree that I will not use drones while camping on property as I do not have Photo Permission

 - I Agree that my party of adults and children with me agree to each item in this waiver and that photos may be taken and used for              Social Media and Print Media uses by Honesdale/Pocono KOA Holiday & its affiliates.

 - I understand there will be no refunds and I agree to all Sites – RV, Tent, Cabins/Deluxe Cabin fees/payments and deposits, and my visitor(s), visitor fees and any store purchases while Camping.

- I agree to all campground rules & visitor fees as stated on the campground map/rules

- I understand that RV, Tent, and Cabin sites do not support EV charging.  No tents are allowed on RV or Cabin Sites. Sites must be in the same condition as arrival, all trash must be put in dumpsters, & I will not move fire rings.

- I understand and have read the above Waiver for me and my undersigned. I am signing below for my credit/debit card payments for this reservation along with my Charge To Site payments. 

 

I Agree
GATE KEY - I agree if I do not return my site Gate Key my credit card will be charged $35.  I will not use my key for any guests or anyone not listed on my reservation.




First Participant's Name
First Name*
Last Name*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
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.
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*
Phone*
Parent or Guardian's Date of Birth*
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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