Form Builder

Mineral Collection Application and Waiver of Liability

Release of Liability, Waiver of Claims, Assumption of Risks and Indemnity Agreement

Please read carefully. You must agree to the following terms in order to be granted permission to collect.

In consideration of the permission granted to me for any use of unpatented mining claims held by the Corporation of the Municipality of Highlands East in the County of Haliburton, Ontario by the owners, occupiers, and/or rights holders, and all persons and organizations facilitating such use of the Property including the Corporation of the Municipality of Highlands East (altogether, the “Releasees”), I hereby freely and voluntarily agree to and execute this document under the following terms and conditions:

  • I am aware of and acknowledge that visiting a rural or other property involves many serious inherent, unmarked or unforeseen risks, and freely accept and fully assume all such risks, including but not limited to those related to the terrain (e.g. slopes, cliffs and caves), wild and domestic animals and plants, weather, water quality and quantity buildings and structures excavations and mines, road and trail conditions, navigation, communications and rescue, frequency of inspections, my physical and mental conditions and abilities the breach of any duty, and neglegence on the part of the releasees or others.
  • I am aware that the property has not been inspected nor maintained by the releasee and agree to waive any and all claims that I now have or may in the future have against the property loss, damage, expense or injury, including death, that I may suffer or that my next of kin or others may suffer, as a result of my use of the premises due to any cause whatsoever, including negligence, tort, breach of contract, or breach of any duty of care.
  • I agree to hold harmless and indemnify the releasees for any and all liability, claims, or causes of action, either in law or in equity, for any property damage, loss, personal injury to or death of any third party resulting from my use of the Property.
  • This Release Agreement shall be binding upon my heirs, executors and administrators. Any rights, duties, obligations, and litigation as between the parties to this Release Agreement shall be solely governed by and interpreted in accordance with the laws and courts of the Province of Ontario and no other jurisdiction.
  • I confirm that I am aware of, and agree to abide by, all appropriate legislation, signs, directions, safety precautions, best practices and codes of conduct that govern the activities in which I may engage.
  • I warrant that I am fully 18 years of age and that I am fit for the uses of the Property.
  • I am not relying on nor am I induced to participate by any oral, written or visual representations, signs, media or statements made by the Releases.
  • I confirm that I have read and understand this release agreement prior to signing it, that I assume all risks and am responsible for my own safety, and that I am aware that, by signing this release agreement, I am waiving or giving up certain legal rights which or my heirs, executors and administrators may have against the releasees.
  • I agree that by signing this form electronically I am bound pursuant to section 19(3) of the electronic commerce act that my signing of this waiver is not invalid or unenforceable by reason only of being in electronic form.

Electronic Signature

Applicant Contact Information

Address

Collection Details

Please plan ahead. It can take up to three business days for your application to be processed and your permission to collect to be granted. Keep this in mind when selecting your dates below.

Emergency Contact

We will use this in case of an emergency while you are at the site.