Porcupettes Up Close

I,                                                                                          , acknowledge that I have voluntarily applied to the Maymont Foundation (Maymont) to participate in its Porcupettes Up Close program. I am aware that the experience could be considered to include some hazardous activities. I am voluntarily participating in these activities with knowledge of the potential risks involved, hereby agree to accept any and all risks of injury, and verify this statement by placing my initials here:                         .

As consideration for being permitted by Maymont to participate in these activities, I hereby agree that I, my heirs, executors, administrators and assigns will not make any claim against or sue for damage, however caused, by any employee, agent or contractor of Maymont as a result of my participation in its Porcupettes Up Close program. I also hereby release Maymont, its directors, officers, agents and employees from any claims, demands, damages, actions or causes of actions arising out of or in consequence of any loss, injury or damage to my person or property incurred while attending or participating in the Porcupettes Up Close program, notwithstanding that any such loss, injury or damage may have arisen by reason of negligence by Maymont, its agents or employees. I also understand that my Porcupettes Up Close may need to be rescheduled due to unforeseen circumstances, such as animal unpredictability.

I understand and accept that Maymont reserves the right, at any time, to refuse, without penalty or obligation, to refund any amount paid by me or terminate my continued participation in the program, in Maymont’s sole discretion, if my participation becomes a hazard to me or other members of the program, or the animals.

I hereby assign and transfer to Maymont and its assigns all rights, title and interest whatsoever, which I have in the photographs, motion picture, sound recordings or video footage which Maymont or their representatives have taken of me. I consent to the use by Maymont and its assigns use of the images, motion picture, sound recording or video footage for all purposes whatsoever (including without limitation: television, publication and/or any trade, advertising usage or stock sales) in perpetuity, worldwide. I agree that all photographs, motion picture, sound recordings or video footage of me, and all duplicates are Maymont’s property, and Maymont may dispose of all or any of them in any manner whatsoever, without any accountability to me.

I hereby release Maymont and its assigns from all actions, debts, accounts, claims, contracts and demands whatsoever, including any claim of my moral rights, which I or my heirs may have at any time as a result of the images, motion pictures, sound recordings or video footage and any matter that may arise out of or in connection with the consent given by me in this release.

I do            or do not           permit Maymont to use my image for promotional purposes.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I UNDERSTAND THAT THIS IS A RELEASE OF LIABILITY AND SIGN OF MY OWN FREE WILL.

Dated:                     

Signature:                                                           

Signature of Parent or Guardian (if applicant is under the age of 18):