49th District Agricultural Association

Lake County Fair

Release and Waiver of Liability Agreement

I, _________________________ (“Participant”), acknowledge that I have voluntarily

Please print full name

applied to participate in the flowing activities at the Lake County Fair Grounds (“Fair”):

81st Annual Lake County Rodeo

July 9 and 10th, 2010

I am aware that the above-described activities are hazardous activities, and I am voluntarily participating in these activities with the knowledge of the danger involved, and agree to assume any and all risks of bodily injury, death, or property damage.

• I verify this statement by placing my initials here:_______.

• Parent or guardian initials (if under 18 years of age)______.

As consideration for being permitted by the Fair, and the State of California, to participate in these activities in these activities, and use their facilities, I hereby agree that I, my assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives will not make claim against, sue or attach the property of the Fair, the State of California or any of their affiliated organizations for injury or damage resulting from the negligence or other acts, however caused, by and director, employee, agent, or contractor of the Fair, the State of California, or any of their affiliated organization as a result of my participation in the activities described above. I forever release the Fair, the State of California, and any of their affiliated organizations from any and all actions, claims, or demands that I, my assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives now have or may hereafter have for injury or damage resulting form my participation in the activities described above.

I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself and the fair, the State of California, and/or their affiliated organizations and sign it of my own free will.

Executed at __________, California, on ________, 2010.

Participant/Releaser Parent or Guardian

X____________________ X____________________

Signature                                    Signature

Address:_________________ Address:________________

                                                                                                                           _________________                          _________________

_________________                          _________________

Phone:__________________ Phone: _________________

• If you are under 18 years of age, you and your parent or guardian must sign and initial this form where indicated.