Complete this REQUIRED form ONLY if you are an adult (18 and Over). If applicant is under 18, waiver must be completed and signed by parent or legal guardian.

REQUEST, RELEASE AND WAIVER OF ALL CLAIMS AGREEMENT

I hereby request that the Palm Beach Radio Control Association (PBRCA) allow me the privilege of flying radio-controlled aircraft at West Delray Regional Park. I have been informed of and I know the risks and dangers involved in the operation of radio-controlled aircraft, and that unanticipated and unexpected dangers may arise during such activities and I assume all risks of injury to me and my property that may be sustained in connection with the stated activities, including, without limitation, the potential crash and loss of my aircraft and its on-board equipment and personal injury. In consideration of the permission granted to me to participate in the stated activities, I do hereby, remise and discharge PBRCA, board members and volunteer flight instructors in the stated activities of and from all claims, loss, damages, demands, actions, and other causes of action of any sort, for injuries to person and/or property during or as a result of participating in any of the activities contemplated by this Agreement, whether such loss, damage, or injury results from the negligence of PBRCA, their officers, board members, volunteer flight instructors or from any other cause. I represent and certify that I am over 18 years old, and that I am a member in good standing of the Academy of Model Aeronautics (AMA), or parent or legal guardian of minor applicant.

In consideration for myself or my child to participate in PBRCA activities and/or flying radio-controlled aircraft at West Delray Regional Park, I, the participant, parent or legal guardian of participant agree to protect, defend, reimburse, indemnify and hold Palm Beach County, its agents, designees, employees, and elected officials free and harmless at all times from and against all claims, liability, expenses, losses, costs, fines, damages or causes of action of every kind and character, including attorney's fees and costs, whether at trial or appellate levels or otherwise, arising during, as a result of, or in connection with my or my child's participation in this activity. I hereby assume the risk of participation in this activity and in consideration for myself or my child's participation in the activity, I agree to hold Palm Beach County, its agents, designees, employees, and elected officials free and harmless at all times from and against all claims, liability, expenses, losses, costs, fines, damages or causes of action of every kind and character, including attorney's fees and costs, whether at trial or appellate levels or otherwise, due to their acts, errors or omissions resulting in bodily injury, including death, or damage to my or my child's property incident to or in connection with my or my child's participation in this activity or with my or my child's transportation for medical treatment. I further understand that I shall be responsible for any and all costs associated with the transportation of myself or my child for medical treatment. Permission is hereby granted for myself or my child to participate in PBRCA and Palm Beach County Parks and Recreation Department activities. I have read the above and understand it and hereby agree that I will not hold Palm Beach County liable for any injuries that may occur as a result of participation in the recreation activities provided by PBRCA and Palm Beach County.

I HAVE READ, UNDERSTAND AND AGREE TO THE FOREGOING REQUEST

IMPORTANT – Please Read: All applicants should be aware and understand that the activities involved in the flying of model airplanes and helicopters are not without some degree of hazard. Therefore, it is the obligation of all members and guests to abide by AMA, PBRCA, Palm Beach County, and common sense safety guidelines to minimize these hazards and to assist the PBRCA Board in their attempt to provide a safe environment for all members and visitors. PBRCA, its Board of Directors, Officers, individually or collectively, will not be held liable for incidents involving injury or property damage, including, but not limited to, loss of aircraft. By submitting this membership application, you hereby acknowledge and accept these conditions.

APPLICATIONS WILL NOT BE PROCESSED UNLESS ALL REQUIRED FORMS, DOCUMENTS AND PAYMENT ARE SUBMITTED AND COMPLETED CORRECTLY

Signature _________________________________________     Date ______________