ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT FOR VOLUNTEERS OR GUESTS OF EVENTS HELD AT OR BY DURWARD’S GLEN OLRG LTD. W11876 MCLEISCH ROAD, BARABOO, WI 53913 Activity: Volunteering at Durward’s Glen Retreat Center (the “Activity”) Participant’s Name (Please print): ____________________________________________________ (the “Participant”) In consideration for permitting Participant to participate as a volunteer in the Activity as directed by the relevant staff, the undersigned, for themselves, and for their respective heirs, personal representatives, and assigns, agree as follows: Assumption of Risk: The undersigned hereby acknowledge and agree that they understand the nature of the Activity; that Participant is qualified, in good health, and in proper physical condition to participate therein; that there are certain inherent risks and dangers associated with the Activity; and that, except as expressly set forth herein, they, knowingly and voluntarily, accept, and assume responsibility for, each of these risks and dangers, and all other risks and dangers that could arise out of, or occur during, Participant’s participation in the Activity. Release and Waiver: The undersigned hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Durward's Glen OLRG Ltd, or any subdivision thereof, and each of them, their officers and employees, (collectively, the “Releases”), from and for any liability resulting from any personal injury, accident or illness (including death), and/or property loss, however caused, arising from, or in any way related to, Participant’s participation in the Activity, except for those caused by the willful misconduct, gross negligence or intentional torts of the above parties, as applicable. Indemnification and Hold Harmless: The undersigned also hereby agree to INDEMNIFY, DEFEND AND HOLD the Releases HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities including, but not limited to, attorney’s fees, arising from, or in any way related to, Participant’s participation in the Activity, except for those arising out of the willful misconduct, gross negligence or intentional torts of the above parties, as applicable. Photo & Video Release: The undersigned grants permission to the rights of the participant’s image, likeness and sound voice as recorded on audio or video tape without payment or any other consideration. The undersigned also understands that images may be edited, copied, exhibited, published or distributed and waives the right to inspect or approve the finished product wherein likeness appears. Severability: The undersigned expressly agree that the foregoing assumption of risk, release and waiver of liability and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of Wisconsin and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Acknowledgment of Understanding: The undersigned have read this assumption of risk, release and waiver of liability and indemnity agreement, and have had the opportunity to ask questions about the same. The undersigned fully understand this assumption of risk, release and waiver of liability and indemnity agreement, that the undersigned are giving up substantial rights in connection therewith, and that its terms are contractual, and not a mere recital. The undersigned acknowledge that they are signing this agreement freely and voluntarily. Signature of Participant _____________________________________________________ Date____________________________ Signature of Parent or Guardian of Participant that under 18 years of age _____________________________________________________ Date____________________________ IF YOU ARE UNDER 18 YEARS OF AGE, YOU AND YOUR PARENT OR GUARDIAN MUST SIGN AND INITIAL THIS FORM WHERE INDICATED.