ALL PARTICIPANTS of the Palencia Witches Ride must agree to the following waiver. Waivers will also be available at packet pick up. Those without signed waivers will not be allowed to participate. Please read carefully. 

Participant waiver and hold harmless form

1. In consideration for receiving permission to participate in Palencia Witches Ride (herein referred to as ACTIVITY), I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE, AND AGREE TO HOLD HARMLESS for any and all purposes Palencia Witches Ride, and its officers, servants, agents, sponsors, volunteers, employees or Dreams Come True of Jacksonville, Inc. (herein referred to as RELEASEES) FROM ANY AND ALL LIABILITIES, CLAIMS, DEMANDS, OR INJURY, INCLUDING DEATH, that may be sustained by me while participating in such activity, or while on the premises owned or leased by RELEASEES, or other location used for ACTIVITY, at any other location, during any free time, or while traveling to or returning from the location where the ACTIVITY takes place, including injuries sustained as a result of the negligence of RELEASEES. I acknowledge there may be physically strenuous activities. I know of no medical reason why I should not participate.

2. I am fully aware that there are inherent risks involved with ACTIVITY and I choose to voluntarily participate in said activity with full knowledge that said activity may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me as a result of participating in said activity including injuries sustained as a result of the negligence of RELEASEES. I further agree to indemnify and hold harmless the RELEASEES for any loss, liability, damage or costs, including court costs and attorney’s fees that may occur as a result of my participation in said activity, including any injury, death, or

loss sustained while traveling to or from ACTIVITY.

3. I acknowledge that if transportation to and from ACTIVITY is not provided by Palencia Witches Ride and that if transportation is provided by others, the owners of such vehicles are solely responsible for provision of any bodily, injury, and property damage insurance as may be required by law.

4. I understand that RELEASEES do not maintain any insurance policy covering any circumstance arising from my participation in this activity or any event related to that participation. As such, I am aware that I should review my personal insurance coverage. I understand that should I be injured while traveling, my personal insurance will be responsible for the treatment of my injuries. If I do not carry personal health insurance, I understand that I am personally financially responsible for the treatment of my injuries.

5. Consent to Emergency Medical Treatment: Palencia Witches Ride may (but is not obligated to) take any actions it considers to be warranted under the circumstances regarding my health and safety. In case of an emergency that calls for medical care, hospitalization or surgery, I authorize Palencia Witches Ride, by and through its authorized representative(s) or agent(s) in charge of this ACTIVITY to secure any treatment which appears reasonably necessary under the circumstances. It is understood that such treatment shall be solely at my expense. I understand that the agents for this ACTIVITY are not trained on medical care.

6. It is my express intent that this Covenant Not to Sue and Agreement to Hold Harmless shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be governed by the laws of the State of Florida.

7. In signing this Covenant Not to Sue and Agreement to Hold Harmless, I acknowledge and

represent that I have read the foregoing Covenant Not to Sue and Agreement to Hold Harmless, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements apart from the foregoing agreement that has been reduced to writing have been made. I execute this document for

full, adequate and complete consideration fully intending to be bound by the same, now and in the future.

By entering the Palencia Witches Ride and participating in the ACTIVITIES, I hereby grant Palencia Witches Ride and Dreams Come True on behalf of myself, and on behalf of my child(ren)/ward(s), the irrevocable right and permission to photograph and/or record me or my child(ren)/ward(s) in connection with Palencia Witches Ride and to use the photograph and/or recording for promotional purposes. I waive any right to inspect or approve the use of the photograph and/or recording, and acknowledge and agree that the rights granted to this release are without compensation of any kind.