I.  VISITOR STATUS

I would like my minor child to visit and tour farm activities at Little Buckets Farm Sanctuary (“the Sanctuary”).  Because the child is a minor, this Minor Visitor Assumption of Risk, Indemnity, and Release of All Claims will be signed by me, in my capacity as the parent or guardian of a minor child.

II.  RISKS OF VISITS

I understand that the activities at the Sanctuary involve serious risks, physical labor, exposure to hazardous conditions, or other circumstances that may result in personal injuries. My minor child may be exposed to, for example, but not limited to: insects; wildlife; Sanctuary animals; inclement weather; extreme temperatures; heavy machinery; tools; the actions and negligence of employees, volunteers, and other people present on the Sanctuary; and dangerous conditions on the land such as holes in the ground or wire fences. I understand that these examples are not all-inclusive and there may be additional risks, all of which may involve serious personal injury, death, or damage to my or my minor child’s property. 

III.  ASSUMPTION OF THE RISK

I and my family, heirs, and personal representatives agree to assume all of the risks and responsibilities of my minor child visiting the Sanctuary. I certify that I have health insurance for my minor child, and I agree to be financially responsible for any medical care costs and treatment for my minor child arising while the minor child is visiting the Sanctuary.  I understand that I am solely responsible for any hospital or other costs arising out of any personal injury or property damage relating to my minor child’s visit to the Sanctuary. 

IV.  RELEASE OF CLAIMS AND INDEMNITY

I and my family, heirs, and personal representatives willingly and knowingly release the Sanctuary, Susan Klingenberg, and its officers, owners, employees and agents from any and all liability for any personal injury or damage to my minor child or the child’s property relating to my minor child visiting the Sanctuary.   In exchange for my minor child’s opportunity to visit the Sanctuary, I agree to indemnify and hold harmless Little Buckets and Susan Klingenberg, its related entities, partners, agents, officers, directors, employees, attorneys, heirs, successors, and assigns from and against any and all claims, losses, damages, judgments, settlements, costs and expenses (including reasonable attorneys' fees and expenses), and liabilities of every kind incurred as a result of any act or omission by Little Buckets and Susan Klingenberg, or its officers, directors, employees, or agents; for any personal injury or property damage my minor child may incur as a result of my visiting the Sanctuary.  This indemnity shall require the payment of costs and expenses by the parent/guardian of the minor child visitor as they occur.  This section shall survive any termination or expiration of this agreement.

V.  MEDICAL CARE AUTHORIZED

I certify that my minor child is physically fit to visit the Sanctuary. I have disclosed below any and all allergies or relevant medical conditions of the minor child to the Sanctuary. I agree that the Sanctuary is not responsible for administering medical treatment of any kind. I understand that there are no medical services available on site or otherwise, and I give permission to the Sanctuary to authorize emergency medical treatment for my minor child. I release the Sanctuary and Susan Klingenberg, and its officers, owners, employees and agents, from liability for any injury or damage that might extend from such emergency medical treatment for my minor child.   

VI.  PHOTOGRAPHIC RELEASE

I agree to grant and convey irrevocably all right, title, and interest in any and all photographic images, and video and audio recordings made by the Sanctuary during my minor child’s visit to the Sanctuary and I give permission to the Sanctuary to use these images or recordings in any way to support the Sanctuary. We rarely post pictures of children and would only ever do so in a fashion that would not include their name.

VII.  CONFIDENTIALITY

I acknowledge and agree that I will be permitted to utilize Little Buckets’ name for the sole and limited purpose of promoting the Sanctuary and I warrant that I will not release any confidential information about the Sanctuary.