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Release and Indemnification Agreement
Waiver: In consideration of being permitted to visit or participate in any way in any activity at the
following environmental lands under the management of Pinellas County, Department of Parks &
Conservation Resources (list properties):
I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and
covenant not to sue Pinellas County, its officers, employees, and agents from liability from any and all
claims including the negligence of Pinellas County, its officers, employees, and agents, resulting in
personal injury, accidents or illness (including death), and property loss arising from, but not limited to
visitation or participation in any way in any activity at the above location.
Signature of Minor’s Parent/Guardian
Signature of Participant
Assumptions of Risks: Visitation or participation carries with it certain inherent risks that cannot be
eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to
another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains to 2) major
injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions 3)
catastrophic injuries including paralysis and death 4) injuries from encountering wildlife including
poisonous snakes, carnivores, and stinging insects.
I have read the previous paragraph and I know, understand, and appreciate these and other risks that
are inherent in visitation or participation. I hereby assert that my visitation or participation is voluntary
and I knowingly assume all such risks.
Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD Pinellas County
harmless from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities,
including attorney’s fees brought as a result of my involvement in visitation or participa