The undersigned is over 21 years of age and has read this form and attached regulations and agrees to comply with them. He/she agrees to be responsible to the municipality for the use and the care of the facilities. He/she on behalf of:

 does hereby covenant and agree to defend, indemnify, and hold harmless the Town of Forestport from and against any and all liability, loss, damages, claims, or actions (including costs and attorneys fees) for bodily injury and/or property damage, to the extent permissible by law, arising out of or in connection with the act or proposed use of the Town of Forest port’s property, facilities, and or services by: