MWP & its Programs - Liability and Publicity Waiver PUNTA GORDA

MY WARRIOR'S PLACE & ITS PROGRAMS

Liability and Publicity Waiver while staying at or visiting MWP in PUNTA GORDA, FL
I UNDERSTAND AND AGREE THAT THIS LIABILTY and PUBLICITY WAIVER IS VALID FROM THE DATE SIGNED BY ME BELOW UNTIL I REVOKE THIS WAIVER (IN PART OR IN FULL) IN WRITING AND SEND IT BY CERTIFIED MAIL TO MY WARRIOR'S PLACE: 105 22nd St. NW #10 Ruskin, FL 33570
Legal Name (First & Last)*
E-mail*
Phone Number*
Include area code
I am a (Check all that apply):

Military Service MemberLaw Enforcement OfficerFirefighterVeteranLaw Enforcement (Retired)Firefighter (Retired)Blue Star Family MemberLEO Family MemberFirefighter Family MemberGold Star Family MemberSilver Star Family MemberGUEST of an American Hero
I have already been Vetted (provided proof of service or of being a family member of a hero)*

Yes, I have been vetted & have my cardNo, I will need to be vetted upon arrivalNo, I will just be a guest of an American Hero
If you are to be a guest of an American Hero, please give us their name:
I UNDERSTAND AND AGREE THAT DURING MY TIME AT MY WARRIOR'S PLACE, EITHER AS A GUEST FOR A DAY OR AS A GUEST AT AN EVENT AT MY WARRIOR'S PLACE, I HAVE THE ABILITY TO USE ANY, BUT NOT LIMITED TO, THE FOLLOWING AMENITIES: Kayaks, Canoes, Paddle Boats, use of Fishing Equipment to fish on Property Lake/Pond, use of Grills and smokers, use of Outdoor Event Areas, and use of any other amenities not listed including walking onto/use of the adjacent Wetland Wildlife Preserve.
Liability Release:

I understand and agree to hereby release My Warrior's Place, Inc. and its Programs, Directors, Officers, Employees, Agents, Representatives and Volunteers, and each of them, and any related parties from any and all claims for injury, death or property damage suffered by me either as a willing participant or as a spectator throughout an activity or event that was conducted by or made possible by the efforts of My Warrior's Place and/or any of its programs and any of its “Parties Released” as stated above, even if such is caused by the negligence or fault of the “Parties Released”.
I agree to the above Liability Release*

YesNo
My Initials act as my signature:*
Publicity Permission:

Videotaping and/or photography may occur during your time out at MWP. I understand that My Warrior's Place & its programs may use such material in future publicity, website and/or any additional outlets for educational and/or promotional efforts. I consent to having my voice and/or image recorded or photographed for use as outlined above.
I agree to the above Publicity Permission*

YesNo
My Initials act as my signature:*
*Note: If bringing any minor children (under the age of 18) with you, you must be their parent or legal guardian and provide the name and age of all children you will be bringing to MWP.
Name of Minor Child:
Age:
Name of Minor Child:
Age:
Name of Minor Child:
Age:
Name of Minor Child:
Age:
Name of Minor Child:
Age:
Name of Minor Child:
Age:
Liability & Publicity Release for Minor Children:

I understand and agree to hereby release My Warrior's Place, Inc. and its Programs, Directors, Officers, Employees, Agents, Representatives and Volunteers, and each of them, and any related parties from any and all claims for injury, death or property damage suffered by any of the minor children listed above either as a willing participant or as a spectator throughout an activity or event that was conducted by or made possible by the efforts of My Warrior's Place and/or any of its programs and any of its “Parties Released” as stated above, even if such is caused by the negligence or fault of the “Parties Released”. Also, I understand that Videotaping and/or photography may occur during our time out at MWP. I understand that My Warrior's Place & its programs may use such material in future publicity, website and/or any additional outlets for educational and/or promotional efforts. I consent to any minor children with me, as listed above, having their voice and/or image recorded or photographed for use as outlines above. I am legally able to waive these rights for the minor children listed above who will be with me and I am personally responsible for them.
I agree to the Release for Minor Children

YesNo
My Initials act as my signature:
Date Submitted

MonthDayYear
My Warrior's Place and all of our Programs appreciates the sacrifice and service made by all of our American Heroes and their families.
Should be Empty:

MY WARRIOR'S PLACE & ITS PROGRAMS

Liability Release:

Publicity Permission:

Liability & Publicity Release for Minor Children: