LONGVIEW GOLF CENTRE, 10300 NW 54^TH AVENUE, GRIMES, IOWA 50111

 515-986-9799 / FAX 515-986-4433

PARTICIPANT RELEASE AND WAIVER OF LIABILITY

ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

In consideration of participating in any way in any of the “activities” (defined as, but not limited to, any field activity, competition or physical training) offered or allowed by Longview Golf Centre and it’s Grimes, IA location and also their directors, officers, employees, agents, members, volunteers, participants, and all other persons or entities acting in any capacity on Longview’s behalf, I hereby agree to release, discharge and indemnify Longview Golf Center, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, person representatives and estate, as follows:

I acknowledge, agree and represent that I understand the nature of the Activities offered at Longview Golf Centre, and that I am qualified, in good health, and in proper physical condition to participate in any Activity that I see fit, of my own choosing and voluntarily. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. I CERTIFY THAT I HAVE ADEQUATE INSURANCE TO COVER ANY INJURY OR DAMAGE I may suffer or cause while participating in any of the Activities offered at Longview Golf Center. I agree to bear the costs of such injury or damage myself. I FURTHER CERTIFY that I am willing to assume the risk of any medical or physical condition that I may have. I FULLY UNDERSTAND THAT: (a) THE OFFERED ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“RISKS”); (b) these risks and dangers may be caused by my own actions or inaction’s or actions of others participating in the activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE “RELEASEES” NAMED BELOW OR THE NEGLIGENCE OF THIRD PARTIES; © there may be other Risks, and social and economic losses, either not known to me or not readily foreseeable at this time, and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES that I incur as a result of my participation of that of the minor in the Activity. I HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE LONGVIEW GOLF CENTRE, their respective administrators directors, officers, employees, agents, members, volunteers, and other participants, any sponsors, advertisers, and, if applicable, owner and lessors of premises on which the Activity take place, (each considered one of the “RELEASEES” herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR THIRD PARTIES, INCLUDING NEGLIGENT RESCUE OPERATIONS, AND I FURTHER AGREE that if, despite signing this release, I or anyone on my behalf, makes a claim against any of the “RELEASEES”, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE “RELEASEES” from any litigation expenses, attorney feels, loss, liability, damage or cost which may incur as a result of such claim. I AGREE TO ALL TERMS OF THIS AGREEMENT APPLY TO THE RISKS OF ANY ACTIVITY ON THE PREMISES.

I FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING SHALL CONTINUE IN FULL FORCE AND EFFECT.

Participants Name ___________________________________________________Date of Birth _________________________

Parents Name (if under the age of 18)__________________________________________Home Phone ___________________

Street ________________________________________________ City ___________________ State _______ Zip ___________

E-Mail Address _____________________________________________ Cell Phone ____________________________________

Signature (parents signature required if under the age of 18)_____________________________________Date ____________