RELEASE BY ADULTS  (or completed by parent for participants under 18)

 I, (print name) _____________________________________________________________________________________________________,  while on the property of The Empty Jug, may hunt, fish, swim, participate in sport shooting (skeet, trap and paintball), and engage in other related activities (collectively referred to as the AActivities@) and I understand that there are potential risk and dangers in participating in these Activities. I, on behalf of my myself and my heirs, executors, administrators, and personal representatives, and intending to be legally bound, do hereby release and forever discharge owners of the Empty Jug, its members, employees, agents, successors and assigns (the AJug@) of and from any and all liability resulting from any claim, demand, action or right of action, of any kind or nature, either in law or in equity, in connection with any loss or liability for or on account of any injury (including death) or damages received or sustained by me by reason of or related to my participation in the Activities.

This agreement constitutes the entire agreement and understanding between the parties and shall be governed by, and construed in accordance with the laws of the Commonwealth of Pennsylvania.

 

Participant Name
(print clearly)

 

Witnessed by
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Participant Address
(print clearly)
Witness Address
(print clearly)

 

 

Signature Signature