• Mother/Daughter Self-Defense Class Sign-Up

    Review the waver below and complete the signature section below to acknowledge the waiver and register to participate in the class.
  • RELEASE AND WAIVER OF LIABILITY AGREEMENT

    I, ___________________________, acknowledge that I have voluntarily accepted permission to enter certain areas of  Southbury Green (the “Property”) located at 775 Main Street South, Southbury CT for the purposes of participating in the "Mother Daughter Self Defense Class".

    In exchange for being allowed to enter the Property and for other good and valuable consideration, the receipt and sufficiency of which I acknowledge, I hereby freely and voluntarily execute this Release and agree to the following terms:

    1.              Assumption of Risk. I am aware and understand that participating in the “Mother Daughter Self Defense Class” may be inherently dangerous and may expose me to a variety of foreseen and unforeseen hazards and risks. I acknowledge that I am voluntarily entering the Property and am voluntarily participating in the Mother Daughter Self Defense Class and have considered those risks. I hereby expressly and specifically assume such risks, including any and all risk of injury, harm, or loss that I may incur as a result of my participation in the "Mother Daughter Self Defense Class".

    2.              Release and Waiver.

    (a)             I hereby fully and forever release and discharge Regency Centers, L.P., and its past, present and future parent(s), subsidiaries, predecessors, successors, affiliates, officers, directors, agents, members, and employees (collectively “Regency”) from, and expressly waive, any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, arising out of or in any way relating to my entering the Property. I promise not to make or bring any such claim or demand against Regency and fully and forever release and discharge Regency from liability under such claims or demands.

    (b)            I UNDERSTAND THAT THIS RELEASE DISCHARGES REGENCY FROM ANY LIABILITY OR CLAIM THAT I MAY HAVE AGAINST REGENCY WITH RESPECT TO ANY BODILY INJURY, PERSONAL INJURY, ILLNESS, DEATH, PROPERTY DAMAGE, OR PROPERTY LOSS THAT MAY RESULT FROM MY VISIT TO THE PROPERTY, WHETHER CAUSED BY THE NEGLIGENCE OF REGENCY OR OTHERWISE.

    3.              Insurance. I UNDERSTAND THAT REGENCY DOES NOT ASSUME ANY RESPONSIBILITY FOR OR OBLIGATION TO PROVIDE FINANCIAL ASSISTANCE OR OTHER ASSISTANCE, INCLUDING BUT NOT LIMITED TO MEDICAL, HEALTH, OR DISABILITY INSURANCE OF ANY NATURE IN THE EVENT OF MY INJURY, ILLNESS, OR DEATH, OR DAMAGE TO OR LOSS OF MY PROPERTY.

    4.              Indemnification. I hereby agree to indemnify, defend, and hold harmless Regency from any and all liability, losses, damages, judgments, or expenses, including attorneys' fees and legal expenses that it may incur or sustain arising out of or relating to my visit to the Property, or arising out of any third-party claim relating to my visit to the Property.

    5.              Miscellaneous. I hereby agree that this Release represents the full understanding between Regency and me and supersedes all other prior agreements, understandings, representations, and warranties, both written and oral, between us, with respect to the subject matter hereof. If any term or provision of this Release shall be held to be invalid by any court of competent jurisdiction, that term or provision shall be deemed modified so as to be valid and enforceable to the full extent permitted. The invalidity of any such term or provision shall not otherwise affect the validity or enforceability of the remaining terms and provisions. This Release is binding on and inures to the benefit of Regency and me and our respective heirs, executors, administrators, legal representatives, successors, and permitted assigns. Section headings are for convenience of reference only and shall not define, modify, expand, or limit any of the terms of this Release.

    6.              Governing Law and Applicable Jurisdiction. I hereby agree that this Release is intended to be as broad and inclusive as permitted, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Florida, without reference to any choice of law doctrine.  Any disputes arising out of or in any way relating to the visit, Regency, or this Agreement shall be brought before state or federal courts located in Jacksonville, Florida. 

     

    BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE REGENCY.

     

    Signature of Visitor: _____________________________________________________

    Name of Visitor (please print): _____________________________________________

    Date: ____________________________________________________________________

     

     

  • Date of Signature (Mother)*
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  • Date of Signature (Daughter)*
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