Youth-Led Kid’s Cooking Demonstration
Friday, July 17th - 12:00pm to 1:30pm
Attendee Information
Please fill name and contact information of attendee.
Name of Parent/Guardian
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First Name
Last Name
Email Address
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example@example.com
Contact Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Zip Code
Name of Child
First Name
Last Name
Age of Child:
Your relationship to the Child:
Are you also registering for more than one minor? (You must be the parent or legal guardian to complete registration on their behalf.)
*
Yes
No
Name of Child 2:
First Name
Last Name
Age of Child 2:
Your relationship to the Child 2:
Release of Liability and Assumption of Risk
UNDER NORTH CAROLINA LAW, THERE IS NO LIABILITY FOR AN INJURY TO OR DEATH OF A PARTICIPANT IN AN AGRITOURISM ACTIVITY CONDUCTED AT THIS AGRITOURISM LOCATION IF SUCH INJURY OR DEATH RESULTS FROM THE INHERENT RISKS OF THE AGRITOURISM ACTIVITY. INHERENT RISKS OF AGRITOURISM ACTIVITIES INCLUDE, AMONG OTHERS, RISKS OF INJURY INHERENT TO LAND, EQUIPMENT, AND ANIMALS, AS WELL AS THE POTENTIAL FOR YOU TO ACT IN A NEGLIGENT MANNER THAT MAY CONTRIBUTE TO YOUR INJURY OR DEATH. YOU ARE ASSUMING THE RISK OF PARTICIPATING IN THIS AGRITOURISM ACTIVITY. The individual named below (referred to as “I” or “me”) desires to participate in a volunteer farming and gardening activity (the “Activity”) provided by Bland Landscaping Co., Inc. and Burkett Farm, LLC (the “Companies”) on property located at 201 Vineyard Lane, Cary, North Carolina, 27513. As lawful consideration for being permitted to participate in the Activity, I agree to all the terms and conditions set forth in this agreement (this “Agreement”). I AM AWARE AND UNDERSTAND THAT THE ACTIVITIES ARE DANGEROUS ACTIVITIES AND INVOLVE THE RISK OF SERIOUS INJURY AND/OR DEATH AND/OR PROPERTY DAMAGE. I ACKNOWLEDGE THAT ANY INJURIES THAT I SUSTAIN MAY BE COMPOUNDED BY NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE COMPANIES, THE PROPERTY OWNERS OR THE LESSEE. I ACKNOWLEDGE THAT I AM VOLUNTARILY PARTICIPATING IN THE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DEATH OR PROPERTY DAMAGE, WHETHER CAUSED BY THE NEGLIGENCE OF THE COMPANIES, PROPERTY OWNERS, LESSEE, OR OTHERWISE. I hereby expressly waive and release any and all claims, now known or hereafter known in any jurisdiction throughout the world, against the property owners, John and Virginia Sall (“Property Owners”), BURKETT FARM LLC (“Lessee”), the Companies, and the Companies', Property Owners’ and Lessee’s officers, directors, members, managers, employees, agents, affiliates, shareholders, successors and assigns (collectively with the Companies, the Property Owners and Lessee, the “Releasees”), on account of injury, death or property damage arising out of or attributable to the Activities, whether arising out of the negligence of the Releasees or otherwise. I covenant not to make or bring any such claim against any Releasee, and forever release and discharge the Releasees from liability under such claims. I shall defend, indemnify and hold harmless the Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorney fees, fees and the costs of enforcing any right to indemnification under this Agreement and the cost of pursuing any insurance providers, arising out or resulting from any claim of a third party related to the Activities. I further understand that the Releasees will not cover me by any insurance including but not limited to medical, property, health, liability insurance and workers' compensation benefits. This Agreement constitutes the sole and entire agreement of the Property Owners, the Lessee, the Companies and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Agreement is invalid, illegal or unenforceable in any jurisdiction, such invalidity, illegality or unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction. This Agreement is binding on and shall inure to the benefit of the Property Owners, the Lessee, the Companies and me and their respective successors and assigns. All matters arising out of or relating to this Agreement shall be governed by and construed in accordance with the internal laws of the State of North Carolina without giving effect to any choice or conflict of law provision or rule (whether of the State of North Carolina or any other jurisdiction). Any claim or cause of action arising under this Agreement may be brought only in the federal and state courts located in Wake County, North Carolina and I hereby consent to the exclusive jurisdiction of such courts. If the individual participating in the Activity is a minor, the parent or legal guardian of such minor must sign this Release and Assumption of Risk on the minor’s behalf. The parent or legal guardian so signing represents that he/she has authority to so sign and hereby agrees to defend, indemnify and hold harmless the Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorney fees, fees and the costs of enforcing any right to indemnification under this Agreement and the cost of pursuing any insurance providers, arising out of or resulting from any claim related to the minor’s participation in the Activities, and including, but not limited to, claims that may be asserted by the minor, claims he/she may assert on behalf of the minor, and/or claims he/she may assert on behalf of himself/herself.
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