Winter Festival Waiver - Re*Imagine Medical Lake

Please complete the waiver for your family.

Contact Person(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agreement(Required)

I agree to the release, hold harmless, and not to sue.

Participant Liability Waiver-Re*Imagine Medical Lake

Release, hold harmless, and agree not to sue

I, fully understand that me and my child’s participation in the Re*Imagine Medical Lake’s activity, event exposes me/my child to the risk of personnel injury, or damage to or loss of personal property. I hereby acknowledge that I am voluntarily participating/allowing my child to participate in the event and agree to assume any and all such risk. Children under the age of 15 will be required to have a parent/guardian escort them during the entirety of the event and the parent/guardian assumes all associated risks.

I assume responsibility for the safety and wellbeing of all participants associated with my parade entry.

I hereby release, discharge and agree not to sue Re*Imagine Medical Lake, it’s board members, the City of Medical Lake or its employees, Cela’s Creative Learning Center, Wispies Hair Salon, Farm Salvation, Johnson Homestead, Pizza Factory, KR Creative Strategies, Owl Pharmacy, Medical Lake School District, and or any organization or business associated with the event for an injury, illness, death or damage associated to or loss of personal property arising out of, or in connection with my participation in the event from whatever cause.

In consideration for me and/or my child being permitted to participate in the event, I hereby agree, for myself and/or my child, my and my child’s heirs, administrators, executors and assigns that I shall indemnify and hold harmless Re*Imagine Medical Lake, it’s board members, the City of Medical lake and its employees, Cela’s Creative Learning Center, Wispies Hair Salon, Farm Salvation, Johnson Homestead, KR Creative Strategies, Owl Pharmacy, The Vault, Medical Lake School District, and any organization or business associated with the event from any and all claims, demands, actions or suits arising out of or in connection with my participation in the event.

By signing I affirm I have carefully read this release, hold harmless, and agree not to sue and fully understand its contents. I am aware that it is a full release of all liability and sign of my own free will.

I agree that pictures may be taken during this event and may be used for promotional purposes.

Kylie Stein
Festival Director (509)418-4481

Full Name of Authorized Participant(s)(Required)

Signature (Typed Name)(Required)

Place Signed (City, State)(Required)

Today's Date(Required)

I understand that if this form is submitted electronically, my typed name on the signature line will qualify as my signature for purposes of the above certification.(Required)

Agreed

Get Alerts & Reminders About Future Events

Name(Required)

Email(Required)

Phone

This field is for validation purposes and should be left unchanged.