Orange County NC Website
14 <br />Exhibit E <br />WORKER ACKNOWLEDGEMENT AND RELEASE <br />I, ________________________________, hereby acknowledge that I have entered into an <br />agreement to work under the supervision of ______________________________ (“TABLE”) at <br />Twin Creeks Future Park which is owned by Orange County subject to the terms and conditions <br />of the License Agreement between ORANGE COUNTY and TABLE dated <br />______________________________ (the “License Agreement”). I acknowledge that I have <br />received a copy of, read, and understand the License Agreement and agree to abide by its terms <br />and restrictions, including but not limited to: Section 5 – TABLE’s Use of the Property, Section <br />17 – Indemnification; Section 18 – Hazardous Materials; and Section 20 – Disclaimer of Liability. <br />I ACKNOWLEDGE THAT BY SIGNING THIS DOCUMENT, WHICH INCORPORATES THE <br />TERMS OF THE LICENSE AGREEMENT, I AM RELEASING ORANGE COUNTY FROM <br />ANY LIABILITY ARISING OUT OF MY WORK FOR THE I SIGN IT OF MY OWN FREE <br />WILL. <br />(SAMPLE – NOT FOR SIGNATURE) <br />___________________________________ <br />Signature <br />___________________________________ <br />Name (printed) <br />___________________________________ <br />Today’s Date <br />___________________________________ <br />Telephone <br />___________________________________ <br />Email <br />Docusign Envelope ID: E79A8BDE-1CFC-4438-8134-B9F0C70B7053