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24 SEPT 09--PHOENIX MAGAZINE ARTICLE ON OUR MOGOLLON MONSTER
3836 East Dewberry Avenue
Mesa, AZ 85206
ph: 480 694 2871
ChiefMon
ACCIDENT WAIVER AND RELEASE OF LIABILITY
I acknowledge that MogollonMonster.com activivities are a test of a person’s physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition environment, equipment, vehicular traffic, lack of hydration, animals and actions of other people; including but not limited to, participants, volunteers, spectators, instructors, and/or guides. I hereby assume all of the risks of participating and/or volunteering in these events. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit, have sufficiently trained for participation in these events, and have not been advised otherwise by a qualified medical person.
I acknowledge that the activity organizers in which I may participate will use this Accident Waiver and Release of Liability (AWRL) form; and that it will govern my actions and responsibilities at said activities.
In consideration of my application, and permitting me to participate in these events; I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release, and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter accrue to me or my traveling to and from this event; THE FOLLOWING ENTITIES OR PERSONS: MogollonMonster.com their directors, officers, employees, volunteers, representatives, and agents, the event holders, event sponsors, event directors, event volunteers; and (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during these events.
I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during these events.
I understand that at these events or related activities, I may be photographed and/or video taped. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and/or assigns. I understand the loctions to be invesitgated during the events are confidential, and I promise and hereby give my word of honor, I will not disclose the location of the areas being investigated by MogollonMonster.com to any non-participant/s of the event or other outside agencies. I will not disclose or take any other person/s to these locations without written conscent from MogollonMonster.com
THIS AGREEMENT IS VALID FOR 1 CALENDAR YEAR BASED ON THE SIGNATURE DATE BELOW
This AWRL shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I hereby certify that I have read this document; and I understand its content.
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PRINT NAME AGE SIGNATURE DATE
PARENT GUARDIAN WAIVER FOR MINORS (Under 18 years old)
The undersigned parent, and natural guardian or legal guardian, does hereby represent that he/she is, in fact, acting in such capacity, and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act; and release said parties on behalf of the minor and the parents or legal guardian.
________________________________________________________________________ PRINT NAME AGE SIGNATURE DATE
YOU MAY CUT AND PASTE THIS WAIVER INTO WORD FORMAT, PRINT IT, AND MAIL IT TO US AT THE ADDRESS LISTED ON THE RIGHT SIDE MENU.
SECURITY/GOOD BEHAVIOR DEPOSIT INFORMATION: DUE TO THE CRITICAL NATURE OF LOCATING AND OBSERVING THE MOGOLLON MONSTER, WE MUST TAKE GREAT CARE NOT TO DISTURB THEM OR HARASS THEM TO THE POINT WHERE THEY MOVE OUT OF THEIR HABITAT. TO ENSURE CONTROL OF BEHAVIOR AND TO REDUCE THE NUMBER OF NON SERIOUS RESEARCHERS, WE HAVE ELECTED TO REQUIRE THIS DEPOSIT FOR FIRST TIME ATTENDEES. WE ARE NOT CHARGING ANY FEES TO ATTEND AN EVENT, AND THIS DEPOSIT IS REFUNDABLE.
WE ARE CURRENTLY ESTABLISHING A WEB PAGE WHICH WILL ISSUE A RECEIPT, BUT FOR NOW YOU CAN MAKE THE PAYMENT THROUGH PAY PAL ON THE PRODUCTS AND SERVICES PAGE. PAYMENT MUST BE MADE AT A MINIMUM OF 5 DAYS PRIOR TO THE EVENT.
3836 East Dewberry Avenue
Mesa, AZ 85206
ph: 480 694 2871
ChiefMon