Please read or have someone read this form carefully to you. Fill in the appropriate information on name, address etc. Your part to fill in comes after the legalese.
Page 2 is for your Vision Specialist. Make sure your Vision Specialist fills out the form or attaches the appropriate visual acuity information.
Finally, have a Notary witness your signature on the Participant line.
After reviewing the Covenant, fill in your Contact Details and click the Print your Event Participation Form link. This will open a new printing window. The form, including the portion for your Vision Specialist and Notary will print along with your Contact information on two pages.
Sorry, but it is a security thing to have a separate print dialog page. Your first option will be to print both pages. The window should close automatically after printing. Due to inconsistencies between browsers, you may have to click print or manually close the window after printing.
When completed, please mail both pages to:
Southeastern Wisconsin Lions BOLD, Inc.
4826 28th Ave.
Kenosha, WI 53140
COVENANT NOT TO SUE
WHEREAS, Southeastern Wisconsin Lions BOLD Inc. (SEWL BOLD, Inc.) a Wisconsin corporation, operates and supervises recreational programs for the blind including but not limited to skiing, horseback riding, camping and similar activities; and
WHEREAS, the undersigned desires to participate in the said programs and is willing to assume the risk attendant to such activities, NOW, THEREFORE, in consideration of being allowed to participate in recreational programs sponsored by SEWL BOLD, Inc., I hereby release and forever discharge for myself and for my heirs, executors, administrators and assigns the said SEWL BOLD, Inc. of and from all claims, demands, damages, actions or causes of action which may hereafter arise on account of any injury which may be sustained by me as a result of, or arising out of, or connected in any way with my participation in any recreational activity or program sponsored by, supervised by, or in any way conducted under the auspices of the said SEWL BOLD, Inc. and which 1, my heirs executors, administrators, or assigns, may have by reason of any such matter, cause or thing.
I further state that I have read and that I understand the foregoing and that I understand that I would not be allowed to participate in the said recreational activities but for the execution of this Agreement.All form fields are required.
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