Items in BOLD are required.
Date:  2/4/2012
Page 2

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First and Last Name
Address
City, State Zip
Day Time Phone Number
Email Address
Child 1: Name and Age
Child 2: Name and Age
Child 3: Name and Age
Volunteer Days
Email List

LIABILITY WAIVER - VISITING INDIVIDUALS/GROUPS

To the fullest extent permitted by law, visiting individuals/groups/volunteers shall indemnify and hold harmless Pinello Ranch, Colorado Springs Utilities, the City of Colorado Springs the Pikes Peak Community Foundation, their collective officers, employees, and insurers from and against all claims, damages, losses and expenses and demands, including court costs, attorney’s fees and expenses, due to injuries, losses and damages arising out of, resulting from or in any manner connected with your activities at Pinello Ranch.



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