SPACE CITY MIXER: RELEASE AND HOLD HARMLESS AGREEMENT

THIS IS A LEGAL DOCUMENT WHICH INCLUDES A RELEASE OF LIABILITY. PLEASE READ IT CAREFULLY BEFORE SIGNING.

1. I understand and accept that a Space City Mixer/Pub Mixer LLC activity may expose me to a variety of risks. Some of the risks which may be present or occur include, but are not limited to:

Ø  The hazards of traveling by foot in rugged terrain;

Ø  Backcountry hazards including loose rocks, falling trees, and river or creek crossings;

Ø  Man-made objects in the area including but not limited to barbed wire, other fences, vehicle and foot bridges, building remains, and garbage or junk;

Ø  Carrying backpacks and other camping equipment;

Ø  Hiking, walking, or running in rugged terrain, including slippery rocks and vegetation;

Ø  Injuries inflicted by animals, insects, reptiles or plants;

Ø  The forces of nature including lightning, weather changes, hypothermia, sunburn, high winds, and others not named;

Ø  The physical exertion associated with the outdoor activity;

Ø  Traveling in a vehicle not driven by me;

Ø  Traveling in terrain that may be inaccessible to emergency vehicles.

2. I have freely chosen to participate. I hereby assume the risks associated with this Space City Mixer activity.

3. I understand that this activity may subject me to rigorous physical exertion. I hereby state that I am in sufficient physical condition to accept a rigorous level of physical activity.

4. I HAVE AND DO HEREBY RELEASE AND WILL HOLD HARMLESS SPACE CITY MIXER / PUBMIXER LLC AND ALL ITS OFFICERS, VOLUNTEERS, GUIDES, EMPLOYEES AND AGENTS, FROM ANY AND ALL LIABILITY, ACTIONS, CAUSES OF ACTION, DEBTS, CLAIMS AND DEMANDS OF EVERY KIND AND NATURE WHATSOEVER, AND SPECIFICALLY INCLUDING ANY CLAIM FOR NEGLIGENCE OR NEGLIGENT ACTS, WHICH I NOW HAVE OR WHICH MAY ARISE OUT OF OR IN CONNECTION WITH OR PARTICIPATION IN THIS ACTIVITY. THE TERMS HEREOF SHALL SERVE AS A RELEASE, INDEMNIFICATION, AND ASSUMPTION OF RISK FOR MY HEIRS, EXECUTORS, AND ADMINISTRATORS AND FOR ALL MEMBERS OF MY FAMILY.

5. Prior to signing this document, I have had an adequate opportunity to read and understand it, have had an opportunity to ask questions about it, and any questions I have had have been answered to my satisfaction.

After reading, please sign below:

Printed Name Signature Date

1) ______

2) ______

3) ______

4) ______

5) ______

6) ______

7) ______

8) ______

9) ______

10) ______

11) ______

12) ______