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Cloverdale Barn
  • Home
  • Cloverdale Cottage
  • Event Creation
    • Barn Details
    • Frequently Asked Questions
    • Related Information
  • Location
    • Map Location
    • Hotels
    • Historical Sites
    • Local Links
  • About Us
  • Fox Meadow Barn @ Cloverdale
  • Contact Us
  • Barn Blogging
    • Testimonials

I,   __________________   ______________________(First  and Last Name) acknowledge that in purchasing this ticket,
I give my child  ___________________________ ___________(First and Last Name) permission
to attend the  Cloverdale Barn Social.  I WAIVE,  RELEASE, and DISCHARGE CloverdaleBarn, its officers and members, and all  business associates and partners involved in the presentation of the above noted activity and each of their officers and employees, from all liability for or by  reason of any damage, loss or injury to person and property, even injury
resulting in the death of the Releasor, which has been or may be sustained in consequence of participation in the activity described above, and  notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Releasee. I hereby acknowledge and agree that I  have carefully read this Waiver and Release agreement, that I fully understand it, and that I am freely and voluntarily executing it.

By signing this release I will be forever prevented from suing or otherwise claiming against the CloverdaleBarn for any property loss or personal  injury that I may sustain while participating in or preparing for the above noted activity and any activities associated with CloverdaleBarn Social.  I understand that I would not be permitted to participate in the
above noted activity unless I signed this agreement. 

I authorize CloverdaleBarn to reserve the right to photograph  and/or videotape for promotional purposes any activities, events and/or programs  that myself and/or my child may participate in.

I understand that this agreement is binding on me, my spouse, my  heirs, my executors, administrators, personal representatives.

Participants parent(s)/guardian(s),  agree if any claim for participant’s personal injury or wrongful death is commenced against releasees, he/she shall indemnify and save harmless releases  from any and all claims or causes of action by whomever or wherever made or  presented for participant’s personal injuries, property damage, or wrongful  death.

This Waiver and Release Agreement will be construed in accordance with and governed by the laws of the State of Virginia, and it is acknowledged by the CloverdaleBarn to be as broad and inclusive as permitted by the laws of  this jurisdiction.

 I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I AM AWARE THAT BY  SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS MAY HAVE AGAINST THE  CloverdaleBarn.
 __________________                 _____________________                   ____
Participant—Last Name                            First Name                          Middle
________________________                    ____________________________            ______      __________
Street Address                                                                       City                      State                Zip Code
 ________________________  ______________________          _________________________
Parent/Guardian—LastName            First Name                            Contact Phone
______________________________________________________________________
Parent/Guardian Signature
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  • Home
  • Cloverdale Cottage
  • Event Creation
    • Barn Details
    • Frequently Asked Questions
    • Related Information
  • Location
    • Map Location
    • Hotels
    • Historical Sites
    • Local Links
  • About Us
  • Fox Meadow Barn @ Cloverdale
  • Contact Us
  • Barn Blogging
    • Testimonials