Bull Run Mountains Conservancy
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RELEASE AND WAIVER OF LIABILITY

BULL RUN MOUNTAINS CONSERVANCY, INC.
Post Office Box 210
Broad Run, Virginia 20137
(703) 753-2631
I acknowledge that mountain hiking can be a dangerous activity which poses potentially serious risks of injury or death, and I have been provided BULL RUN MOUNTAINS CONSERVANCY, INC.'s, "Use Guidelines" which details some of the hazards of the Bull Run Mountains State Natural Area Preserve property and the risks I assume in visiting the property. I expressly agree to assume such risks, agree to abide by the "Use Guidelines," and waive the right to sue BULL RUN MOUNTAINS CONSERVANCY, INC., and/or VIRGINIA OUTDOORS FOUNDATION for any damages, injury, or death that I may sustain as a result of my visiting the Bull Run Mountains State Natural Area Preserve.

In exchange for permission given me by BULL RUN MOUNTAINS CONSERVANCY, INC., and VIRGINIA OUTDOORS FOUNDATION to visit the Bull Run Mountains State Natural Area Preserve, I, for myself, my heirs, personal representatives, successors, and assigns, hereby release and forever discharge BULL RUN MOUNTAINS CONSERVANCY, INC., and VIRGINIA OUTDOORS FOUNDATION, their officers and directors and their respective heirs, personal representatives, successors, and assigns, from any and all claims and causes of action, whether past, present, or future, arising out of my visiting the Bull Run Mountains State Natural Area Preserve property, which is owned by VIRGINIA OUTDOORS FOUNDATION and leased and managed by BULL RUN MOUNTAINS CONSERVANCY, INC. By signing this waiver I realize I am giving up legal rights to which I otherwise may be entitled.

 


Signature

Date

Printed Name

Organization (if any)

License Plate No. of Parked Vehicle

Street Address

City

State

ZIP Code

Telephone

E-mail Address

Witness' Signature

Date
Witness' Address

 

Emergency Contact (Name, City, and Phone Number)

 

PARENTS OR LEGAL GUARDIANS MUST SIGN ON BEHALF OF INDIVIDUALS UNDER 18 YEARS OF AGE.

Yes, I would like to volunteer for:

Events ___

Trail Maintenance ___

Halloween Safari ___

Other ___

 

 

 

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Bull Run Mountains Conservancy Box 210 Broad Run, Virginia 20137
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