PBCA FORMS | Placid Bay Civic Association

FORM #1: KAYAK EVENT LIABILITY FORM (ADULT PARTICIPANT)

RECREATION RELEASE FROM LIABILITY KAYAK EVENT

RELEASE FROM LIABILITY FOR PBCA RECREATIONAL KAYAK EVENT

Date ____________________________

ADULT (18 YEARS AND OLDER)

AGREEMENT AND RELEASE FROM LIABILITY

This Recreation Event Agreement and Release of Liability (this “Agreement and Release”) is executed by the undersigned participant as of the date indicated above and below in favor of Placid Bay Civic Association (PBCA).

Please carefully read each section of this Agreement and Release of Liability and confirm your acceptance with your signature where indicated. Your signature constitutes your irrevocable and unconditional consent to the terms hereof. Failure to sign and date this Agreement and Release will deem you ineligible to participate.

1. PARTICIPATION:I am responsible for my own insurance coverage in the Recreational Event of personal injury or illness arising from the trip or Recreational Event. I agree to refrain from sexual harassment, consisting of, but not limited to, unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature. I further agree that my participation in the activities may be terminated at any time by the PBCA.

2. ASSUMPTION OF RISK: I am aware that, because of this Recreational Event and transportation of my watercraft and myself, I may be exposed to personal injury, illness, death, or damage to my property, and/or to the activities of others.

3. I AGREE TO PARTICIPATE in the Recreational Event in accordance with recognized safe practices including having on board my craft a US Coast Guard approved personal floatation device (PFD) and sounding device. If I am unable to swim, I will wear a PFD when I am on or in the water. I agree to also have a liquid beverage on board so I can keep hydrated.

4. RELEASE: In consideration of the opportunity afforded me to participate in the above Recreational Event, I, on behalf of myself and my successors, assignees, heirs, guardians, and legal representatives, hereby irrevocably and unconditionally:

(a) waive and release any and all claims for personal injury, illness, death or damage to property and any and all claims that arise on account of any first aid, treatment or service rendered to me, in each case, related to or arising out of my voluntary participation (collectively, the “Released Claims”) against Placid Bay Civic Association, and all of their respective officers, directors, contractors, agents and volunteers, any financial or in-kind supplier of any material or equipment that is used, or, any other volunteer or service recipient participating, (collectively, the “Released Parties”); and

(b) agree not to assert or prosecute (or assist any other person or entity in asserting or prosecuting) any Released Claim against any Released Party. I understand and agree that no Released Party assumes any responsibility for or obligation to provide financial or other assistance, including, but not limited to, medical, health and/or life insurance with respect to any Released Claim.

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5. VIDEO/AUDIO MATERIALS RELEASE: I grant and convey to the PBCA all right, title and interest in all photographs, images, video, or audio recordings of me or my likeness or voice made by the PBCA in connection with my providing volunteer services and I consent to PBCA’s unrestricted use of such materials in connection with this Recreational Event.

6. GOVERNING LAW AND SEVERABILITY: I (a) acknowledge that this Agreement and Release is intended to be interpreted as broadly and inclusively as permitted by the laws of the Commonwealth of Virginia, (b) agree that this Agreement and Release shall be governed by the internal laws of the Commonwealth of Virginia, and (c) agree that if any clause or provision of this Agreement and Release is held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release, which shall continue to be enforceable.

7. I have carefully read and understand this Agreement and Release and any questions of mine have been answered. I am aware that this is a contract and a release of liability between myself and the Released Parties. I have signed this Agreement and Release voluntarily and of my own free will. I certify that I am eighteen years of age or older. I agree that this Agreement and Release governs all my activities during the above Recreational Event.

Executed in Westmoreland County, Virginia, on (date): _____________________________________

Name__________________________________________________________________________________

Signature __________________________________________________________________________

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FORM #1: KAYAK EVENT LIABILITY FORM (MINOR PARTICIPANT 17 YEARS OLD OR YOUNGER)

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FORM #3: DEED OF GIFT TO PLACID BAY ESTATES

DEED OF GIFT TO THE PLACID BAY CIVIC ASSOCIATION 67 Mattox Avenue, Colonial Beach, VA 22443

DEED OF GIFT (TOOLS, EQUIPMENT, PHOTOS, VIDEOS, AND OTHER MATERIAL

1. This Gift Deed, made on _____________(DATE) is executed in the State of Virginia, transferring ownership of property from the donor to the done without any consideration or compensation. This Deed is subject to the laws of the State of Virginia, specifically under the Virginia Code § 64.2-312 which governs the voluntary transfer of personal or real property by gift.

2. I_________________________________________ (hereinafter referred to as the “Donor”)

3. Donor’s signature affirms that Donor has the legal authority to give, donate, and convey materials to Placid Bay Estates.

4. Donor hereby gives, donates, and conveys materials to the Placid Bay Civic Association collectively referred to as the “Donee”). Ownership of the materials shall pass to the Donee upon the execution of this Deed of Gift.

5. The Deed of Gift includes_____________________________________________________

____________________________________________________________________________

6. This Deed of Gift is executed on this ______________________(DATE).

Donor (Print Name):__________________________________________________________

Donor (Signature):____________________________________________________________

Placid Bay Estates Board of Director Member (Print Name): ________________________________________________________

Board Member (Signature):____________________________________________________

Date:_________________________________________

PBCA Deed of Gift Form 12.4.24

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