Name *

First Name

Last Name

Date *

MM

DD

YYYY

I accept liability and responsibility for my health safety for working as a volunteer. The inherent risks of activities, dangers, or conditions which are an integral part of activities, include but are not limited to:  (1)  Activity may result in injury, harm or death to persons on or around the property; (2) the unpredictability of the historical infrastructure can result in injury, harm or death to persons; (3) certain hazards such as surface and subsurface conditions; (4) collisions with other tools or objects; (5) the potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as failing to be aware of surroundings or acting in a way that is unsafe.  In accepting liability and responsibility for my health and safety in daily farm activities and chore operations and the use of the barn facilities, I understand that I do so at my own risk and assume full responsibility for any injury or other occurrence arising from such and further agree to indemnify and hold harmless, Norwell Farms and Staff individually from and against any loss, damage, injury, disability, death or other occurrence that may arise now or hereafter from participating in the daily farm activities or use of the barn facilities. Such indemnities shall include but not be limited to losses, damages, injury or liability now suffered or hereafter occurring to my activity of farm work and I agree that I shall not hold Norwell Farms and staff individually or responsible for any such occurrence, damage, loss, personal injury, death or disability.

I have read, understand, and accept responsibility.