Release of Liability and Asumption of Risk Part A

Release of Liability and Asumption of Risk [Part A]

Name (Visitor):…………………………………………………………………… Date ……………………

Name (any minors in my care):

………………………………………………………………………………………………………………………………

Address:

……………………………………………………………………………………………………………………………….

Phone No: ………………………………………… Email (optional):...... ……………..

Contact Name & Ph. No. in case of emergency:

...... ………………………………….

SSAA/Hunting Club Membership No: ...... ………………….

Driver’s License No: ...... ………………………………………………...

Shooters License No. …………………………………………………………………………..

Car Registration No. …………………………………………………………………………..

The visitor enters the property known as ‘Willunga’ (the property) and participates in the activities provided by the owner of the property and its employees and agents (the Owner) at their own risk and on the condition that the visitor signs this disclaimer. The visitor will be referred to in this disclaimer as “I”, “me” and “my” and the owner is referred to in this disclaimer as “you” and “your”.

I acknowledge that if I do not agree with this disclaimer or believe I cannot follow your rules and regulations then I must not remain on the property.

I am aware that during my visit to the property and during the activities which I have chosen to participate in, including but not limited to hunting, bushwalking, swimming and travelling across the property by vehicle, I will be exposed to risks inherently associated with these activities, including but not limited to those in the ‘Risk Awareness Statement’ and I acknowledge that I am only allowed to visit the property on the understanding that I do so at my own risk.

In consideration of and as payment for the right to participate in such activities and receive the services that you provide for me, I do hereby assume all of the risk of entering the property and participating in such activities and will continue to hold you free from any liability, action, cause of action, debt, claim and demand of any kind arising, or contributed to by my visit to the property whatsoever or howsoever occurring, including, without restriction, any Act of God or your negligence. My signature and acknowledgement of the terms hereof shall serve as a release for you from all liability and an assumption of risk for myself, my heirs, executors and administrators and for all members of my family including any minors accompanying me.

Please read the above ‘Release of Liability and Assumption of Risk’ paragraphs carefully. These paragraphs mean the owner will not be responsible if you (the visitor) are injured, have an accident or damage property whilst on ‘Willunga’. These paragraphs must be fully understood before signing.

Signed: ...... Name: ……………………………………….. Date…………………..

Witnessed: ...... Name: ………………………………………. Date……………………

Parents or guardians must sign for all persons under age 18

(To be signed in presence of witness)