-- select a trip -- Habitat Gardening Workshop, May 19

Number of adults:

Adult/s name/s:

E-mail address/es:

Phone number/s:

Waiver and release

I release the Willow Bend Environmental Education Center and any / all local program partners, including their employees and clients from all claims, demands, and actions for injury sustained by myself and/or my property. I agree to accept sole responsibility and liability for any injury or damage to a third party resulting from my participation in the Willow Bend Environmental Education Center’s programs and agree to indemnify, save and hold the Willow Bend Environmental Education Center and any/all local program partners including their employees and clients, collectively or individually, harmless from any such claims.

I also agree that the Willow Bend Environmental Education Center has my permission to take and use photos and videos and audio tapes of my participation in all program activities which will be used for program documentation ad publicity purposes.

I certify and understand that my attendance and participation in Willow Bend Environmental Education Center’s programs are strictly voluntary. I have read and understood the conditions stated above.

I ACKNOWLEDGE THAT I HAVE READ THE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT VOLUNTARILY. I VERIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT.