ACTIVITIES CONSENT FORM FOR
WALLY LAKE FEST AUGUST 28-30, 2015
Downtown Hawley Partnership (DHP), Pocono Mountains Visitors Bureau (PMVB), The Chamber of the Northern Poconos, Lakewatch, Wallenpaupack Area School District (WASD), Alice’s Wonderland, NEWE and Paupack Sailing Club, non-profit corporations, will be conducting activities for Wally Lake Fest August 28-30, 2015, within the Wallenpaupack Lake Region and Downtown Hawley Region. These activities are for the benefit of the adults and children of the community. The Downtown Hawley Partnership (DHP), Pocono Mountains Visitors Bureau (PMVB), Pocono Lake Region Chamber of Commerce (PLRCC), Lakewatch, Wallenpaupack Area School District (WASD), Alice’s Wonderland, NEWE and Paupack Sailing Club, allows Wally Lake Fest to use its facilities as a public service to the members of the community.
Every person who registers for the activities is required to sign this Consent Form. In consideration for being allowed to participate in the activities, you agree to assume the risks and hazards of the program. Further, you agree to hold harmless and indemnify Downtown Hawley Partnership (DHP), Pocono Mountains Visitors Bureau (PMVB), The Chamber of the Northern Poconos, Lakewatch, Wallenpaupack Area School District (WASD), Alice’s Wonderland, NEWE and Paupack Sailing Club, its agents or employees from any and all claims, suits, losses or related causes of action for damages, including but not limited to, such claims that may result from your injury or death, accidental or otherwise, during or arising in any way from your participation in the activities or use of Downtown Hawley Partnership (DHP), Pocono Mountains Visitors Bureau (PMVB), The Chamber of the Northern Poconos, Lakewatch, Wallenpaupack Area School District (WASD), Alice’s Wonderland, NEWE and Paupack Sailing Club facilities.
Your execution of this form indicates that you have read the same in its entirety and that you have voluntarily agreed to assume the risks or participating in the activity.
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SIGNATURE - 18 AND OLDER (PARENT/GUARDIAN)
DATED: _____________ __________________________
PRINT NAME
Please PRINT names of children under 18, in your care, that are participating:
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YES, I would like to receive more information about Hawley, PA from the Downtown Hawley Partnership. E-mail address: ________________________________________ (Your e-mail address will not be shared or sold!)