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Submit using Internet Explorer ONLY! <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 />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 />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, <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 Pequot Lakes, on a form approved by the City. <br />Participant Release and Indemnification required? YES NO <br />Special Events Holder Initials Here: <br />S:1A.dministrationlLicenseslSpecial Event PermitslRelease Indemnification Agreement 12-28- <br />17.docx <br />