Hold Harmless Agreement Template for Special Event Permit - City of Sonora, California

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SPECIAL EVENT PERMIT
HOLD HARMLESS AGREEMENT
I/We the undersigned, being of lawful age, by affixing my/our signatures hereto, do hereby agree to
indemnify and to hold harmless the City of Sonora, its officers, employees, elected officials and
agents, from and against any and all liability claims, actions, causes of action, demands, rights,
damages, cost, loss of service, expenses, and compensation for all negligence whether active or
passive arising out of or in any way connected or related to
___________________________________
to be held on ___________________________.
(Name of Event)
(Date)
____________________________________________________________
Name of sponsoring Individual(s) or Organization/Group
____________________________________________________________
Address
_________________________
___________________________
Phone No. (include Area Code)
Email Address
I understand by affixing my signature to this release that I do assume all risks and waive
defendant’s negligence, including a release of heirs.
Furthermore, the undersigned hereby acknowledges receipt of the Special Event Permit Application
and willingness to adhere to its provisions.
AUTHORIZED REPRESENTATIVE
(To be completed by individuals representing an Organization or Group)
I, _____________________, warrant that I have authority to bind ____________________________
(Name of individual)
(Name of Organization/Group)
to this Hold Harmless Agreement and by my signature hereon do so bind this
individual/organization. By executing this waiver as an authorized representative you are hereby
binding all of your organization/group’s individuals participating in this event to this waiver and
hereby assume responsibility for these individuals.
________________________________________________
________________________
Signature
Date
___________________________________________
________________________
Signature
Date
For Minors:
(required for participants under the age of 18 at the time of the event)
This is to certify that I, as parent or legal guardian, have legal responsibility for this participant. I
have read and understand the significance of this waiver and release and do consent and agree to
his/her waiver, release and assumption of the risk as provided above.
__________________________________________________________
(Print Name of Parent/Legal Guardian)
______________________________________________
______________
Signature
Date
SPECIAL EVENT PERMIT
HOLD HARMLESS AGREEMENT
I/We the undersigned, being of lawful age, by affixing my/our signatures hereto, do hereby agree to
indemnify and to hold harmless the City of Sonora, its officers, employees, elected officials and
agents, from and against any and all liability claims, actions, causes of action, demands, rights,
damages, cost, loss of service, expenses, and compensation for all negligence whether active or
passive arising out of or in any way connected or related to
___________________________________
to be held on ___________________________.
(Name of Event)
(Date)
____________________________________________________________
Name of sponsoring Individual(s) or Organization/Group
____________________________________________________________
Address
_________________________
___________________________
Phone No. (include Area Code)
Email Address
I understand by affixing my signature to this release that I do assume all risks and waive
defendant’s negligence, including a release of heirs.
Furthermore, the undersigned hereby acknowledges receipt of the Special Event Permit Application
and willingness to adhere to its provisions.
AUTHORIZED REPRESENTATIVE
(To be completed by individuals representing an Organization or Group)
I, _____________________, warrant that I have authority to bind ____________________________
(Name of individual)
(Name of Organization/Group)
to this Hold Harmless Agreement and by my signature hereon do so bind this
individual/organization. By executing this waiver as an authorized representative you are hereby
binding all of your organization/group’s individuals participating in this event to this waiver and
hereby assume responsibility for these individuals.
________________________________________________
________________________
Signature
Date
___________________________________________
________________________
Signature
Date
For Minors:
(required for participants under the age of 18 at the time of the event)
This is to certify that I, as parent or legal guardian, have legal responsibility for this participant. I
have read and understand the significance of this waiver and release and do consent and agree to
his/her waiver, release and assumption of the risk as provided above.
__________________________________________________________
(Print Name of Parent/Legal Guardian)
______________________________________________
______________
Signature
Date

Download Hold Harmless Agreement Template for Special Event Permit - City of Sonora, California

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