SCHOOL OF TANTRA, TEMPLE OF TANTRA,
TANTRA THEOSPHICAL SOCIETY, & SYNERGY COMMUNITY
SYNERGY COMMUNITY FARMS
WAIVER OF LIABILITY AGREEMENT

I understand that Synergy Community (SC) /Synergy Farms (SF) /Synergy Services, Inc.(SSI) is located in a rustic, hilly and wild area. I and my assignees, heirs, personal and legal representatives, release from liability, hold harmless and will not make any claims (present and future) against Synergy Community (SC) /Synergy Farms (SF) /Synergy Services, Inc.(SSI) or any of its staff, agents, contractors, guests or volunteers for any physical or emotional injury, including death, that may occur to me and accompanying children, animals or adults at Synergy Community (SC) /Synergy Farms (SF) /Synergy Services, Inc.(SSI) ; including but not limited to slipping and falling, use of any pools or water including infections or drowning and use of any trails; including but not limited to any loss of any kind to my property or vehicle, whether resulting from my own acts, the acts of others, acts of God or from acts of any Synergy Community (SC) /Synergy Farms (SF) /Synergy Services, Inc.(SSI) staff, agents, contractors or volunteers. Synergy Community is a private, spiritual members-only organization and reserves the right to terminate the tenancy of a guest or member for reasons Synergy Community (SC) /Synergy Farms (SF) /Synergy Services, Inc.(SSI) shall deem objectionable


Address _________________________________ City _____________________

State/Province __________________________ Zip Code ____________ Country ___________

Phone ____________________ Mobile ___________________

Email ____________________________ Email ____________________________

Car Make ___________________ Car Model ______________________

Car Color ___________________________ Car License ______________________

Arrival Date _______________________ Departure Date ___________________

Member Name ____________________________ Supervisor’s Name ______________________

Member Signature: _________________________ Supervisor’s Signature ____________________

Date ___/___/___ Date ___/___/___