RELEASE, WAIVER, AND ASSUMPTION OF RISK
I, the undersigned am fully aware and understand there are potential risks involved
with the rental of any facility. Specific dangers include, but are not limited to,
slip & falls, tripping, equipment failure or accidents, failure of any fixture,
structure or structural member, burns, cuts, abrasions, severe injury, death or
damage to personal property.
I acknowledge that I am voluntarily renting this facility and participating in the
activities conducted therein. I hereby agree to assume all risk of injury, damage
to persons and property, and/or death, and to indemnify, defend and hold harmless
the City of Palmdale, its officers, agents, volunteers, and employees from any liability
for injuries, claim for damage, damage to goods, or death that may arise in connection
with the renting or use of this facility. This Release, Waiver, and Assumption of
Risk also pertains to any actions of the City of Palmdale, its officers, agents,
volunteers and employees (excepting only the sole negligence or willful misconduct
of the City) which may have caused or contributed to the injury, damage, or death.
This Release, Waiver, and Assumption of Risk shall be binding upon my heirs and
dependents as well as myself.
I hereby certify that I have read and will abide by the Rules and Regulations of
the City of Palmdale and the Department of Parks and Recreation as attached and
any additional rules that are specific to the facility. I understand that fees must
be paid at least ten (10) days in advance of rental or Rental Contract will be cancelled.
I understand that if I cancel this rental I must do so in writing ten (10) days
prior to rental date to receive a refund. I understand a signed Rental Contract
must be received at least ten (10) days prior to rental date. I further agree to
promptly reimburse the City of Palmdale for any clean-up, loss of damage to City
property resulting from its use within five (5) days of conclusion of rental date.
The City reserves the right to cancel any rental without liability to the Department
upon ten (10) days written notice to Renter.
(must be 21 years of age):
*Signature of applicant