Golden’s Bridge Fire District

Hold Harmless Agreement

I wish to use the facility owned and/or maintained by the Golden’s Bridge Fire District (GBFD)
for the purposes of _____________________.  I understand that I will be charged a fee for use, and that, in additional consideration for allowing me to use the facility, GBFD expects that I will be legally responsible for all that may occur relative to my activities, and that I will further hold GBFD harmless for all claims of any type that might result from my activities.  Specifically, I understand:

1. GBFD does not supervise my activities or the facilities in any fashion.

Alcohol is not permitted on or in the property.

I certify that all activities will be in full compliance with any local, state, or federal laws or regulations.

2. I cannot rely upon GBFD for assurances, expressed or implied, that my activities
will not cause harm to me or others.  By allowing me to utilize the facility, GBFD is also making no assurances whatsoever that no harm will come to me, my invitees, or my guests either by my activities, or by the facility itself.  I am fully responsible to ensure that the facility is adequate to engage in my activities safely, and in the event that I deem that they are not, I will refrain from any activities.  This will be my sole responsibility.

3. I understand the activity that I will engage in and the risks associated with the activity. 
The GBFD provides me with no information in this regard, and that in the case that I am not able to hold the activity safety I will refrain from any activities.  This will be my sole responsibility.

4. Not only do I agree to be legally responsible and defend, indemnify, and hold harmless
GBFD or any of their agents or employees for any harm that may come to me, my fellow members, my guests, or my invitees as a result, direct or indirect, to me as a result of the activities or as a result of the facilities, but in consideration of the use of the facility, I further agree to defend, indemnify, and hold harmless GBFD, or any of their employees for any claims, including those resulting from alleged acts of negligence on any of their part.

5. It is my knowing intention to provide the GBFD, and any of their agents,
employees or members the broadest protections against lawsuits that are available.

I have read the above information, agree to it, and have had an opportunity to ask any questions that I have.  If I am signing on behalf of an organization, I certify that I am authorized to agree to the terms and conditions of this agreement on my behalf of the organization, and the organization's’ members.

Signed______________________ Organization________________________ Date___________

Facility Usage Check-off Form

0   Received signed hold harmless agreement.

0   Received copy of current Homeowner’s or Organization Insurance Policy.

0   Explained areas which are “off-limits” for guests.  

0   Explained condition hall is expected to be in upon conclusion. 

0   Explained organization’s smoking policy.

0   Explained organization’s alcohol policy. 

0   Explained proper use of:

       0   Cooking Appliances    

0   Slicer  

0   Automated Devices   

0   _____________________

0   _____________________

0   Explained all safety rules.  

The above information has been explained to me and I have had the opportunity to ask any questions that I may have.

Signed: ___________________________________        Date: _________________________

Member Conducting Walk through: ________________________________________________