Camp Creek Hunt Club

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Member Waiver and Indemnification

"CAMP CREEK HUNT CLUB"

105 Pine Valley Drive, Stanley NC 28164

Brandon High, President

www.campcreekhuntclub.org

I,__________________________________________(print name) obtain permission to use "CAMP CREEK HUNT CLUB" land as a member, my heirs, and personal representative, waive and release "CAMP CREEK HUNT CLUB", it's employees, agents, licensees, and representatives (collectively "CAMP CREEK HUNT CLUB") from any claim or loss surrender by me and arising from my use of, or presence on "CAMP CREEK HUNT CLUB" lease.

In addition, I will indemnify and defend "CAMP CREEK HUNT CLUB" from any claims or loss allegedly caused by any act of omission by me and arising from my use of, or presence on, "CAMP CREEK HUNT CLUB" leased land.

____________________________________________________ _______________________________

Signature of Member Date

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Witness

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18)

This is to certify that I, as parent/guardian with legal responsibility for __________________________________, do consent and agree to his/her release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless Camp Creek Hunt Club from any and all liabilities incident to my minor child’s involvement or participation in hunting activities and/or the use of Camp Creek Hunt Club leased land, EVEN IF ARISING FROM THEIR NEGLIGENCE.

Name of Parent/Guardian (Printed)_________________________________

Parent/Guardian Signature________________________________________Date___________________________________