RELEASE, INDEMNIFICATION AND WAIVER FORM:I, the undersigned, hereby acknowledge that I have been advised and fully understand that certain elements of dangerare inherent in the activities sponsored by Hawthorn Farm, LLC which are beyond the control of the agents, students,tenants, and employees of Hawthorn Farm, LLC, and that participation by myself or my family in any activities mayentail unavoidable risk of personal injury, death, and loss of or damage to property. These risks include, but are notlimited to, insect and animal bites and stings, forces of nature such as but not limited to lightning and extreme weatherconditions, use of hand tools and power tools, and any hazard present in the wilderness or suburban farm settings.
I hereby assume all risks of injury and death to my child and loss of or damage to property arising out of my child’sparticipation in such activity and I agree to indemnify, hold harmless Alexia Allen and Daniel Kirchhof and any tenantsand employees there-of or Hawthorn Farm, LLC (“Releasees”) from and against all claims arising from any occurrencecausing damage or injury to myself, my child(ren) or to any party participating in said event or any third parties injuredas a result of my child’s actions. I also confirm that by signing as a Parent/Guardian, I release, waive, and dischargethe Releasees for all claims any parent of my child(ren) might have as a parent or guardian for injury to any child forwhom I have signed. I further agree to repair or reimburse Hawthorn Farm LLC or Alexia Allen for any and alldamages that my child(ren) or family causes to the property at 17340 NE 195th St, Woodinville WA 98072 or whereverthe specific program may be held.
In the event that my child requires medical attention while participating in this program, I hereby grant permission toHawthorn Farm, LLC and its representatives to provide for the rendering of such care, including diagnostic procedures,surgical and medical treatment, by authorized medical staff or their designees, as may in their professional judgmentbe necessary. I hereby acknowledge that I am responsible for all reasonable expenses in connection with care andtreatment rendered during this period.
I grant permission for Alexia Allen, Daniel Kirchhof and Hawthorn Farm to use images and photos of myself or mychildren for promotion of Hawthorn Farm website, programs or newsletters.
Prior to signing below, I have read and understood the terms and conditions of this Release, Indemnification, andWaiver, understand by signing below I am waiving certain legal rights I may have against the Releasees, and I agreeto subscribe to all the terms and conditions set out above.