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Lexington Conservation – Wildlife Camera Use & Waiver Form
Participant’s Name
Street Address
E-mail
Emergency Contact
Emergency Phone
RELEASE AND WAIVER OF LIABILITY
I, the undersigned, in consideration of being permitted to use cameras to capture wildlife on Lexington
Conservation Lands do forever RELEASE, acquit, discharge, and covenant to hold harmless the Town of
Lexington, the Lexington Conservation Commission, the Lexington Land Stewards, and all of their officials,
members, officers, agents, representatives, employees, assigns, successors, servants, and designees from any
and all actions, demands, omissions, suits, damages, liabilities, losses, costs, causes of action, and claims,
including but not limited to negligence, both at law and in equity, on account of, or in any way growing out of,
directly or indirectly, all known and unknown personal injuries or property damage arising out of or related to
the use of wildlife cameras, and other Lexington Conservation Office programs, wherever it occurs.
Date Signature
MINOR RELEASE (must be signed by a parent or guardian if the participant is under 18 years of age)
AND I, THE PARENT AND/OR LEGAL GUARDIAN of , a minor, understand the nature
of wildlife camera use activities, and other programs organized and/or operated by the Town of Lexington’s
Conservation Office, and the minor’s experience and capabilities, and I believe the minor to be qualified, in
good health, and in proper physical condition to participate in said activities. I do hereby consent to the
minor’s participation in any said wildlife camera use activities, and other Lexington Conservation Office
programs. I hereby release, discharge, and covenant to hold harmless the Town of Lexington, the Lexington
Conservation Office, the Lexington Land Stewards, and all of their officials, members, officers, agents,
representatives, employees, assigns, successors, servants and designees from any and all actions, demands,
omissions, suits, damages, liabilities, losses, costs, causes of action, and claims, including but not limited to
negligence, both at law and in equity, in any way growing out of or in connection with, directly or indirectly,
all known and unknown personal injuries or property damage arising out of or related to the minor’s
participation in any part of said wildlife camera use activities or Town of Lexington Conservation Office
programs, wherever it occurs, which I may now or hereafter have as the parent and/or legal guardian of said
minor or which the minor has or hereafter may acquire, either before he/she or after he/she has reached his/her
majority resulting from his/her participation in said Town of Lexington wildlife camera use activities, and
other programs.
Date Signature