HOLD HARMLESS AGREEMENT

Between Camp Wyanokie Commission and _____________________________

WITNESSETH: ___________________________________ agrees to release,

indemnify and hold harmless the CAMP WYANOKIE COMMISSION, IT’S

EMPLOYEES, AGENTS OR VOLUNTEERS from any loss, damage and liability,

including attorneys’ fees and expenses incurred by the latter arising out of or in

consequence of the use of the Camp Wyanokie site and facilities. The applicant

has been requested to furnish a Certificate of Insurance with limits of liability

described below: Please indicate amount of coverage.

Workers Compensation/Employers Liability: _____________________________

Automobile Liability: ________________________________________________

Umbrella Liability: __________________________________________________

A true copy of the Certificate of Insurance is attached.

Date ___________________ Signature ___________________________