2014 ANNUAL COVENANT NOT TO SUE, RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

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1 2014 ANNUAL COVENANT NOT TO SUE, RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT LAST NAME DRIVERS LICENSE # EMERGENCY CONTACT: FIRST NAME STATE OF ISSUE RELATIONSHIP: EMERGENCY CONTACT PHONE #: THIS AGREEMENT APPLIES TO CROSSROADS ATV & RECREATION PARK, LLC AND THE ABOVE REFERENCED PARTY. THIS AGREEMENT CONSTITUTES AN EXPRESS CONTRACTUAL ASSUPMPTION OF ALL RISKS, BOTH A WAIVER AND RELEASE FROM ALL LIABILITY FOR ANY NEGLIGENCE OR DANGEROUS CONDITION OF PRIVATE PROPERTY AND INDENITY FOR ALL THIRD PARTY CLAIMS (HEREINAFTER AGREEMENT ). The undersigned FOR and in consideration of and further for and in exchange of CROSSROADS ATV & RECREATION PARK, LLC allowing my paid use of the premises as follows; I know that ATV, including four wheelers, motorcycle, three wheelers, dune buggy, dirt bikes and bicycle riding are each inherently dangerous sports and recreation activities, in which I choose to voluntarily participate at my own risk. I am aware that the inherent and usual great risks, hazards and substantial dangers of personal injury, death and disability or property damage and loss from riding ATV s such as four wheelers, three wheelers, motorcycles, dune buggies, dirt bikes, and bicycles (collectively damages ) necessarily increase when I or others use ramps, trails, traces, unaltered natural terrain, inclines or declines, mud bowls, rough earthen terrain and any man made riding area or earthen terrain. I know that the inherent foreseen and often unforeseen risks, hazards and dangers include, but are not limited to uncontrollable motor propelled ATV'S and bicycles, which can lead to or cause strains, sprains, bruises, broken bones, concussions, heat exhaustion and many other injuries. DEATH and property damage resulting from falling or being thrown from the ATV, wrecking, jumping, landing, performing tricks or other like activities, as well as colliding with other objects, users, staff, bystanders or spectators. I also understand that these inherent, great, increased risks, hazards and dangers are further increased when other persons, whether or not of the same level of experience or skill are present at the same time and use the same facilities. (Any of the above - defined activities are collectively referred to throughout the Agreement as "'The Hazardous Recreational Activities.") By this Agreement, it is my intention to forever relieve CROSSROADS ATV & RECREATION PARK, LLC and anyone associated with and working for CROSSROADS ATV & RECREATION PARK, LLC, including, but not limited to its owners, landlords, officers, employees, and agents, volunteers, sponsors, vendors, contractors and exhibitors of any duty to me and I do assume the entire risk of foreseen or unforeseen, known and unknown, bodily and personal Injury claims, damages, losses, harms, deaths, property claims, medical expenses, hospital expenses, and any other type of personal or property damage claims or expenses that might occur during this agreement. I also intend to forever release, discharge and absolve CROSSROADS ATV & RECREATION PARK, LLC from any and all liability for any active or passive negligence whatsoever by CROSSROADS ATV & RECREATION PARK, LLC and to waive and relinquish any claim, demand or causes of action, of whatsoever kind or nature, known or unknown, against CROSSROADS ATV & RECREATION PARK, LLC for any property damage, loss, expense and for any personal injury, damage, loss, harm, death, hospital or medical expense or any other type of expense Liability Waiver & Agreement - Page 1 of 6

2 caused by any negligence of CROSSROADS ATV & RECREATION PARK, LLC or other persons using The Recreation Area and promise not to sue or exercise any Iegal right to seek damages from CROSSROADS ATV & RECREATION PARK, LLC. By this Agreement, I also intend to and do forever release, discharge, waive and relinquish and absolve CROSSROADS ATV & RECREATION PARK, LLC from any and all claims or causes of action against CROSSROADS ATV & RECREATION PARK, LLC for any property damage, loss or expense and personal injury, damage, loss, harm, death, medical or hospital expense and any other type of expense caused by The Hazardous Recreational Activities and/or by the condition and/or maintenance of The Recreational Area premises or any of its equipment, structures or devices, including but not limited to ramps, trails, traces, unaltered terrain, inclines or declines, mud bowls, rough natural earthen terrain or any man made riding area or altered terrain and promise not to sue or exercise any regal right to seek damages from CROSSROADS ATV & RECREATION PARK, LLC for injuries or death resulting from any activity or any reason whatsoever or for any injuries or damages which occur at The Recreation Area. In consideration of being permitted to utilize for pay The Recreational Area, I agree as follows: As to my participation in any activity, including, but not limited to the Hazardous Recreational Activities and as so, any and all liability and for any injury or damages which I may suffer or incur due to any cause whatsoever, while on The Recreation Area premises, I hereby agree: To forever waive any and all claims for any injury and/or damages that I may have against CROSSROADS ATV & RECREATION PARK, LLC or any other person, landlord, company or entity in any way associated with it. To forever release CROSSROADS ATV & RECREATION PARK, LLC from any and all liability for any injury and for damages that I may suffer or incur, or that my next of kin may suffer as a result of my participation in any activity, including but not limited to the Hazardous Recreational Activities. To forever hold harmless and in indemnify CROSSROADS ATV & RECREATION PARK, LLC from any and all liability for any injury and/or damages to any third party resulting from my participation in any activity including, but not limited to the Hazardous Recreational Activities This waiver and release of liability and indemnification agreement shall be effective and binding upon me, my heirs, next of kin, family, relatives, guardians, conservators, executors, administrators, trustees and assigns in the event of property damages or my injury, disability or death. I have read, understand and agree to be bound by the CROSSROADS ATV & RECREATION PARK, LLC speed limit: NO ALCOHOLIC BEVERAGE USE, and other RULES FOR USE while using The Recreation Area. I understand the rules and agree that violation of the rules may result in loss of The Recreation Area privileges, removal from the area and/or sanctions. Liability Waiver & Agreement - Page 2 of 6

3 I acknowledge and understand that the CROSSROADS ATV & RECREATION PARK, LLC is an AT YOUR OWN RISK recreation facility. CROSSROADS ATV & RECREATION PARK, LLC does not supervise ATV, four wheeler, three wheeler, dune buggy, dirt bike or bicycle use or users and assumes no Responsibility for them. I acknowledge and understand that this Agreement affords CROSSROADS ATV & RECREATION PARK, LLC broader rights and protections than provided by statute and state law and agree to such broader rights and willingly agree to such broader rights and protections for CROSSROADS ATV & RECREATION PARK, LLC. I agree that this Agreement is intended to be at least as broad and inclusive as is permitted by laws of the State of Mississippi and that if any portion of the Agreement is held invalid, it is agreed that the balance shall continue in full legal force and effect. I certify that I have no medical condition that would cause participation in any activities at The Recreation Area to increase the risk of hazard to my health. In addition, I authorize CROSSROADS ATV & RECREATION PARK, LLC to provide or cause to be provided with such medical treatment that may be necessary or appropriate if I am injured while at The Recreation Area, without there being any admission or implication of liability on CROSSROADS ATV & RECREATION PARK, LLC part by doing so. I understand and agree that this Agreement shall remain in full force and effect and bind me, my heirs, estate and assigns for any and all present and future allowed or unauthorized use of The Recreation Area by me. I HAVE READ AND VOULUNTARILY SIGNED AND INITALED all pages of this Agreement and further agree that no oral representations, or inducements apart from this Agreement have been mae by CROSSROADS ATV & RECREATION PARK, LLC with regard to the subject matter of this Agreement. If I am younger than 18 years old, my parent (legal guardian) and I hereby certify that I am younger than 18 years old, that I (we) have completely read and understand this Agreement and its terms. Prior to signing this Agreement, I (we) have had the opportunity to consult an attorney about the effect of this Agreement. I (we) are aware that by signing this Agreement I (we) assume all risks and waive and release all rights that I (we) and my heirs, next of kin, family, relatives, guardians, executors, administrators, trustees and assigns may have CROSSROADS ATV & RECREATION PARK, LLC. I HAVE READ AND FULLY UNDERSTAND AND I AGREE TO ALL THE TERMS OF THIS RELEASE: SIGNATURE DATE Liability Waiver & Agreement - Page 3 of 6

4 ** THIS AGREEMENT MUST BE SIGNED IN THE PRESENCE OF A CROSSROADS ATV & RECREATION PARK, LLC REPRESENTATIVE. WITNESS MY SIGNATURE. MINORS, (UNDER 18 YEARS OF AGE) I, THE UNDERSIGNED, HEREBY CERTIFY THAT I AM THE LEGAL GUARDIAN OF THE BELOW LISTED MINOR PARTICIPANT(S) AND THAT I AM EXECUTING THIS WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT FOR AND ON BEHALF OF SAID MINOR(S), WITH ALL TERMS AND CONDITIONS OF THE ABOVE AND FOREGOING AGREEMENT BEING APPLICABLE TO SAID MINORS, THEIR HEIRS, ASSIGNS, PARENTS, GUARDIANS AS WELL AS THE MINORS LEGAL GUARDIAN. 1. (PRINT NAME OF MINOR PARTICIPANT) 2. (PRINT NAME OF MINOR PARTICIPANT) 3. (PRINT NAME OF MINOR PARTICIPANT) 4. (PRINT NAME OF MINOR PARTICIPANT) X, DATE / / LEGAL GUARDIAN S SIGNATURE IF THE PARTICIPANT IS UNDER 18 YEARS OF AGE AND THE GUARDIAN IS NOT PRESENT UPON PARTICIPANT S ENTRY TO CROSSROADS ATV & RECREATION PARK, LLC, THE LEGAL GUARDIAN S SIGNATURE MUST BE NOTARIZED IN ACCORDANCE WITH THIS WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT. X LEGAL GUARDIAN SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME ON THIS THE DAY OF, 20 BY NOTARY PUBLIC IN AN DFOR THE STATE OF MISSISSIPPI MY COMMISSION EXPIRES: NOTARY S PRINTED NAME: STAMP HERE Liability Waiver & Agreement - Page 4 of 6

5 TERMS: THIS COVENANT NOT TO SUE, RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMINITY AGREEMENT IS IN EFFECT FROM THE DATE OF SIGNING AND CONTINUES FOR ALL FUTURE ACTIVITIES WITHIN THE PARK: DATE: PRINT NAME: ADDRESS: CITY: ADDRESS: Instructions for Completing Minor Forms: Parent/Guardian must fill form out in THEIR name and add minor's name on the last page of consent form. Form MUST be NOTARIZED. SIGNATURE: Liability Waiver & Agreement - Page 5 of 6

6 Crossroads ATV & Recreation Park GENERAL RULES: This is a RIDING park, not a RACING park - 5mph max speed limit on main gravel road that stretches throughout the park. You WILL be held accountable for your actions. Park is not responsible for any damages or injuries to yourself or your property/equipment. All riders must provide an injury release waiver & riders UNDER 18 must provide a NOTARIZED WAIVER before entering the park. VEHICLES No motorcycles, full-size pickups or Jeeps allowed. Dirt bikes ARE welcome. Helmet and protective gear must be worn at all times. One person per dirt bike (no riders.) No street bikes or cruisers. All ATV/UTV/3-wheelers must have working brakes. All ATV/UTV/3-wheelers must have floor board/floor pans/foot guards. Helmets and safety gear are required/madatory for all dirt bike riders. Helmets and safety gear are required for children aged 12 and under operating their own ATV/UTV or dirt bike. Helmets are not required if children aged 12 and under are riding with a parent on ATV/UTV. Any bikes/atvs left on property will become property of Crossroads ATV & Recreation Park. SAFETY No glass containers allowed on the property. Strictly enforced. Possession of glass will result in expulsion from the park. (No refunds.) No ATV/UTV use on MX tracks. You get stuck...you get ustuck. Crossroads WILL NOT use any construction equipment or vehicles on site to aid in recovery No open-toed shoes or flip-flops on riding trails. PROPERTY USAGE & BEHAVIOR You will be allowed ONE warning for any rules-related issue. After first warning, you will be ESCORTED OFF THE PROPERTY. No refunds. Wristbands are required for admittance and for continued use of the facility. Persons found on property without wristbands will be considered as TRESSPASSING and will be prosecuted to the fullest extent of the law. ($450 fine.) No riding on NATCHEZ TRACE wooded buffer zone or roadway. No riding on RAILROAD TRACKS or bottom spur of railroad tracks. No TRESSPASSING on neighboring land (clearly marked yellow signs). No littering. Please use the available trash cans. No nighttime ATV riding (strictly enforced). No firearms or weapons of any sort, to include crossbows, bows, air rifles, knives, etc. No illegal drug use. Courteous language always - NO PROFANITY. No fighting. No ATV riding or bike washing in the lake. No loud music. SIGNATURE DATE Liability Waiver & Agreement - Page 6 of 6

SKATEBOARD COMPETITION ENTRY FORM

CITY OF KISSIMMEE PARKS, RECREATION & PUBLIC FACILITIES SKATEBOARD COMPETITION ENTRY FORM For your convenience, competition entry forms will be accepted in person, by mail, via fax or email at the location