Liability Waiver

Liability Waiver Form

Please complete a separate liability form for each attendee or set of attendees with a different address. For attendees with the same address, you may complete a single form and enter their details there.

Are you with an organization/group?

Name of organization/group:

I am completing this form for:

Your Name *Legal Guardian's First & Last Name

Your Age *Legal Guardian's Age

Your Phone Number *Legal Guardian's Phone Number

# Adults *How many adults are you completing this form for?

# Children *How many children are you completing this form for?

Name of Adult 1 *

Phone for Adult 1 *

Name of Adult 2 *

Phone for Adult 2 *

Name of Adult 3 *

Phone for Adult 3 *

Name of Adult 4 *

Phone for Adult 4 *

Name of Child 1 *

Age of Child 1 *

Name of Child 2 *

Age of Child 2 *

Name of Child 3 *

Age of Child 3 *

Name of Child 4 *

Age of Child 4 *

Name of Child 5 *

Age of Child 5 *

Name of Child 6 *

Age of Child 6 *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Acknowledgement of Risk

As of 03/23/2023, I, {name-12}, acknowledge that I understand that this is a working farm, with the attending inherent risks, and hereby indemnify and hold Harmless, Alpacawaka Barn & pastures, LLC., and its employees or owners from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. This agreement shall continue for each and every visit to the farm’s property.

Please Initial:

Acknowledgement of Risk (Adult 1)

As of 03/23/2023, I, {name-1}, acknowledge that I understand that this is a working farm, with the attending inherent risks, and hereby indemnify and hold Harmless, Alpacawaka Barn & pastures, LLC., and its employees or owners from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. This agreement shall continue for each and every visit to the farm’s property.

Please Initial:

Acknowledgement of Risk (Adult 2)

As of 03/23/2023, I, {name-2}, acknowledge that I understand that this is a working farm, with the attending inherent risks, and hereby indemnify and hold Harmless, Alpacawaka Barn & pastures, LLC., and its employees or owners from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. This agreement shall continue for each and every visit to the farm’s property.

Please Initial:

Acknowledgement of Risk (Adult 3)

As of 03/23/2023, I, {name-4}, acknowledge that I understand that this is a working farm, with the attending inherent risks, and hereby indemnify and hold Harmless, Alpacawaka Barn & pastures, LLC., and its employees or owners from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. This agreement shall continue for each and every visit to the farm’s property.

Please Initial:

Acknowledgement of Risk (Adult 4)

As of 03/23/2023, I, {name-5}, acknowledge that I understand that this is a working farm, with the attending inherent risks, and hereby indemnify and hold Harmless, Alpacawaka Barn & pastures, LLC., and its employees or owners from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. This agreement shall continue for each and every visit to the farm’s property.

Please Initial:

Email Address *Your confirmation email will be sent to this email address.

Contact Us



(757) 450-9446



393 Snowden Rd.
Moyock, NC 27958



alpacawaka@gmail.com

Liability Waiver Form

Contact Us

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