STATE OF
LOUISIANA PARISH
OF TANGIPAHOA

THE HAMMOND ROTARY CLUB, INC. (“Rotary”) agrees that

{rider}(“Rider”) shall ride in the Rotary Club of Hammond’s Christmas Parade of the current
year. Rider has the authority to bind the organization on whose behalf he/she is executing
this Indemnification and Hold Harmless Agreement.
NOW THEREFORE, Rider and Rotary hereby agree as follows: Rider hereby releases
and holds harmless Rotary from and forever discharges it, the Board of Directors,
officers, its heirs, agents and assigns from any and all rights, claims, causes of action,
demands, damages, allegations or suits of any kind or nature whatsoever, and
particularly any and all claims for general and/or special damages as a result of any
personal injury sustained by them during or as a result of the activities of Rider and those
individuals hereinafter named and undersigned in connection with the Rotary Club of
Hammond’s Christmas Parade and the preparatory activities for the same. Rider does
further indemnify Rotary against any and all claims by the individuals hereinafter named
and undersigned, their heirs, agents and/or assigns, including but not limited to, any and
all rights, claims, causes of action, demands, damages, allegations or suits of any kind or
nature whatsoever, and particularly any and all claims for general and/or special damages
as a result of any personal injury sustained by them during or as a result of the activities of
those individuals hereinafter named and undersigned in connection with the Rotary Club
of Hammond’s Christmas Parade. This hold harmless agreement shall be binding upon
the parties hereto, their agents, successors and/or assigns .The undersigned hereby
declare that this hold harmless agreement has been completely read and is fully
understood and voluntarily accepted for the express purpose of precluding forever any
claims against the THE HAMMOND ROTARY CLUB, INC. arising out of the aforesaid
activities.

THUS DONE AND SIGNED, this day of {date} , 2024 , after reading
of the entire document.