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• <br /> Page 1 of 4 <br /> Revised: 12-28-17 <br /> SPECIAL EVENT SPONSOR <br /> WAIVER,RELEASE AND INDEMNIFICATION AGREEMENT <br /> City of Pequot Lakes <br /> 4638 Main Street <br /> t„ Pequot Lakes,MN 56472 <br /> THIS IS A WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION <br /> AGREEMENT. SPECIAL EVENTS HOLDER MUST READ CAREFULLY BEFORE <br /> SIGNING. <br /> In consideration for being permitted to engage in the following special event activities on City of <br /> Pequot Lakes property: <br /> • <br /> Special Events Holder hereby acknowledges.represents,and agrees as follows: <br /> A. We understand that the above described activities are or may be dangerous and do <br /> or may involve risks of injury, loss,or damage to us and/or third parties and we <br /> freely and voluntarily assume any and all such risks. We further acknowledge that <br /> such risks may include, but are not be limited to, bodily injury,personal injury, r' <br /> sickness,disease,death,and property loss or damage,arising from the following <br /> circumstances,among others: <br /> Special Events Holder Initials Here: <br /> B. If required by this paragraph,we agree to require each participant in our special <br /> event to execute a WAIVER, RELEASE AND INDEMNIFICATION <br /> AGREEMENT for the City of Pcquot Lakes,on a form approved by the City. <br /> Participant Release and Indemnification required? YES NO <br /> Special Events Holder Initials Here: c... /'n <br /> \lcplserver-41cityWdministrationlLicenseslSpecial Event Permits\Release Indemnification <br /> Agreement 12-28-17.docx <br /> q <br />