Liability Waiver

By order of our insurance lady, this needs to be filled out and on file here at the farm, if you plan to visit.  Sorry for the inconvenience...



Liability Waiver

NAME: _______________________________________________________ AGE: ____________

ADDRESS: ______________________________________________________________________

CITY/STATE: __________________________________________________ ZIP: _____________

HOME PHONE: _______________________

BUSINESS PHONE: _______________________


ACKNOWLEDGEMENT OF RISK

I, ____________________, acknowledge that I understand that this is a working farm, with the attending inherent risks, and hereby indemnify and hold harmless, Jacob’s Reward Farm, and its employees or owners from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. This agreement shall continue for each and every visit to the farm’s property.

If under 21, the parent or guardian must read and sign the above, indicting his/her acceptance.


Date: _________ Signed: ________________________________
                                           Participant

Date: _________ Signed: ________________________________
                                           Parent/guardian (if minor)