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CITY OF CAPE CANAVERAL
Release and Waiver Agreement ) '�•, � )0 CA1 QC. ) t
I, L z �whose address is knowingly and voluntarily agree to
paficipate l in the Cape Canaveral Community Garden Program at facilities owned by the City of Cape Canaveral("Program").
I acknowledge and understand that this Program is an outdoor activity subject to environmental conditions including, but not limited to,
inclement weather conditions such as rain,hail,and wind storms,extreme sun exposure,and soil exposure. In addition,the Program involves
various levels of manual labor associated with gardening such as lifting and using equipment; frequent body movement such as bending,
kneeling,lifting,standing,and walking;and manipulating and moving soil,compost,and plant materials which will place physical stress on my
body,including but not limited to my muscular and cardiovascular systems. Further,there is risk of animal bites/stings and disease associated
with gardening including,but not limited to,from fire ants,bees,hornets,wasps,mosquitos,fleas,snakes,rodents,birds and other animals that
may be found in a vegetable and flower garden or in the wild. I am aware that it is my responsibility to first consult with my physician or other
health care professional to determine if this Program is right for my needs. I further understand that gardening requires the use of hand tools,
both small and large, such as sharp stakes, spades, rakes, pails, and digging forks, and that some tools such as shears and knives have sharp
cutting edges or points that can cause serious bodily injury and/or death if used incorrectly, callously, negligently or recklessly. I also
understand that I am solely responsible for my safety and that I will undertake precautions of my own choosing,and as I deem appropriate for
my needs,to protect myself against injuries and/or death related to animal bites and disease,sun exposure, adverse weather conditions,manual
tasks, use of tools, and other activities and conditions associated with the Program. I will further be solely responsible for my own personal
belongings that I may use in,or bring to,the Program.
I agree to assume the entire risk of accidents,illness, disease,personal injury,property damage or death which is suffered by me as a result of
participation in the Program, whether or not such damage results from product liability or negligence or gross negligence (except intentional
misconduct)on the part of the City. I understand that the City is not providing any safety measures of any kind for the Program,and that I am
solely responsible for my safety including,but not limited to, providing my own personal protective equipment such as gloves,footwear,dust
masks, safety goggles, ear muffs, sunscreen, hats, allergy medications and products, as I deem appropriate for my own safety. I further agree
that the City has no responsibility for my personal belongings should they become lost or stolen.
I(individually and on the behalf of any spouse,children,relative,beneficiary,estate,personal representative,successor,assign,and all persons
or entities which may derive a claim through me), for and in consideration of the opportunity to participate in the Program, hereby enter into
this Release with the City, and agree to the fullest extent permitted by law and without limitation, to indemnify and hold harmless the City,
from and against all claims,losses,damages,personal injuries(including but not limited to death),or liability(including reasonable attorney's
fees),which directly or indirectly arise out of,or result from,my participation in the Program.
I(individually and on the behalf of any spouse,children,relative,beneficiary,estate,personal representative,successor,assign,and all persons
or entities which may derive a claim through me) hereby remise, release and forever discharge the City from any all claims, accidents,
damages, demands, rights, actions and causes of action of any kind whatsoever, in law or in equity, resulting from my participation in the
Program,which includes and extends to any and all claims I have or may have against the City with respect to the Program and the conditions,
qualifications, instructions, rules or procedures thereof, and, from any other cause whatsoever relating to the Program or occurring during or
after or as a result of the Program. I further agree to accept full responsibility, financial or otherwise,for any injury that I may cause either to
myself or to any other participants due to my acts or omissions while participating in the Program. It is my intention hereby,fully and finally
and forever,to settle and to release any and all matters,disputes and differences,with respect to those matters described herein.
I further agree that this Release is to be broadly construed,and that if any portion of same is held invalid,that the balance of the Release shall
continue in full legal force and effect. It shall have no legal effect on interpretation of this Release that the City has prepared this Release. I
have read,understand,and voluntarily sign this Release and further agree that no oral representations,statements or inducements apart from the
contents of this Release have been made which in anyway alters, amends, or changes this Release. Florida law applies to this Release. I
certify that I am eighteen years or older.
If I allow my minor child(ren)to participate in the Program, I acknowledge and agree that the aforesaid statements shall equally apply to my
minor child(ren)and that I will be solely responsible for supervising my child(ren)participating in the Program at all times.My child(ren)will
not participate in the Program without my adult supervision.The following notice shall also apply:
NOTICE TO THE MINOR CHILD'S
NATURAL GUARDIAN
READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET
YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU
CITY OF CAPE CANAVERAL
Release and Waiver Agreement
ARE AGREEING THAT, EVEN IF THE CITY OF CAPE CANAVERAL (INCLUSIVE OF
ITS ELECTED AND APPOINTED OFFICIALS, OFFICIALS, DIRECTORS, EMPLOYEES,
AGENTS, PROGRAM INSTRUCTORS, ATTORNEYS, AFFILIATED ORGANIZATIONS
AND SPONSORS) (HEREAFTER, COLLECTIVELY REFERRED TO AS THE "CITY")
USES REASONABLE CARE IN PROVIDING THIS PROGRAM ACTIVITY, THERE IS A
CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY
PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS
INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY
SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR
RIGHT TO RECOVER FROM THE CITY IN A LAWSUIT FOR ANY PERSONAL
INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE
THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE
PROGRAM ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM,
AND THE CITY HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF
YOU DO NOT SIGN THIS FORM.
I (INDIVIDUALLY AND ON THE BEHALF OF ANY SPOUSE, MINOR OR ADULT CHILDREN, RELATIVE, BENEFICIARY,
ESTATE,PERSONAL REPRESENTATIVE,SUCCESSOR,ASSIGN,AND ALL PERSONS OR ENTITIES WHICH MAY DERIVE
A CLAIM THROUGH ME)KNOWINGLY,WILLFULLY,FULLY,EXPRESSLY AND COMPLETELY ASSUME ANY AND ALL
RISKS AND LIABILITY, KNOWN OR UNKNOWN, ASSOCIATED WITH MY PARTICIPATION IN THE PROGRAM,
WHETHER OR NOT SAID RISKS ARE EXPRESSLY OR IMPLIEDLY STATED HEREIN. THE CITY OF CAPE CANAVERAL
AND ITS ELECTED AND APPOINTED OFFICIALS, EMPLOYEES,PROGRAM INSTRUCTORS ATTORNEYS,AND AGENTS
("CITY") ARE NOT RESPONSIBLE FOR ANY INJURIES, INCLUDING DEATH, WHICH MAY OCCUR TO ME BEFORE,
DURING,OR AFTER MY PARTICIPATION IN THE PROGRAM.
I have fully read and fully understand the foregoing and in consideration of being allowed to participate in the Program,I fully agree
g
to thee
oing terms and condit'• • herein.
Participant's ame(please print) Participant's Signature Date
CAPE CANAVERAL GARDEN RULES
Visit www.cityofcapecanaveral.org/garden for more information
1. Each gardener is responsible for the maintenance and upkeep of their garden box.
2. A limited number of tools,gloves, hoses, and miscellaneous garden equipment will be available in
the locked garden storage/work table for use during regular park hours.
3. Regularly scheduled work times will be posted on the garden bulletin board/via email.
4. Garden boxes should be cared for at least once a week.
5. Each gardener will be given a combination code to the lock on the garden gate and the storage/work
table for access to tools and watering equipment.
6. Guests and children are welcome in the garden but must be accompanied by an adult/registered
gardener and must be supervised at all times.
7. Each gardener must complete a Release of All Claims form before they can work/volunteer in the
garden.
8. The application of herbicides (weed killers)and non-organic fertilizers to the garden boxes is
prohibited and strictly enforced.
9. Assignment of garden boxes will be awarded by a lottery system.
10. Box fees are due in full to the Community Engagement Director before gardeners take possession of
their boxes and are given the code to the combination lock.
11. Gardeners may harvest vegetables and flowers from their garden box only, unless gardeners agree to
share their garden box or duties.
12. At the end of the growing season, gardeners are responsible for clearing their box of all plant
material,tilling the soil and leaving the box as they received it.
13. Gardeners will not expand garden boxes beyond their measurement or into paths or other boxes.
Gardeners will keep all plants within the limits of their garden box and will not allow any plants to
grow more than six(6)feet high (excluding certain plants e.g. sunflowers). Boxes must be kept free
of weeds, pests and diseases.
14. Illegal plants, weapons, pets/animals, smoking of any kind, profanity,discrimination and drinking of
alcoholic beverages is prohibited in the Community Garden/Patriots Park.
15. Garden boxes will be watered according to water-wise guidelines.
16. Participation in Community Garden meetings,workshops and special events is required.
17. Gardeners are responsible for ensuring that the rules are followed at all times. Breaking any rules,
terms and conditions is cause for immediate exclusion from the garden and forfeit of garden box.
18. Any issues should be communicated to the Community Engagement Director within 24 hours of
incident.
Joshua Surprenant,j.surprenant@cityofcapecanaveral.org(321)868-1240
The Community Engagement Director is the highest governing authority at the Cape Canaveral
Community Garden.
Signed: [Gardener] �J Date:
Approved: Date: