Release and Waiver of Liability
PLEASE READ THIS CAREFULLY
I, ___________________________________, in reserving and using an oxalic acid vaporizer made available by the East Central Iowa Beekeepers Association, acknowledge that I am aware that the use of such a tool involves certain inherent dangers and that I may be subjected to risks that may include but are not limited to inhalation of toxic vapors, burning eyes, chemical burns, physical burns, and contamination of clothing. I acknowledge also that I am freely, voluntarily, and with such knowledge assume the risk of personal injury or damage to my property. I hereby release and agree to indemnify and hold harmless East Central Iowa Beekeepers Association, Urban Realty of 250 Holiday Road, Coralville, Iowa, 52241 and any and all of the agents of Urban Acres Realty including but not limited to Rob McCain, from any and all liability, claims, suits, demands or other causes of action arising out of or related to any loss, injury or damage that may occur to myself or others in the course of using the oxalic acid vaporizer.
Please initial each of the items below:
_______ I agree to read fully the provided instructions for using the vaporizer.
_______ I agree to provide all of my own safety equipment and to use all possible precautions when using the vaporizer.
_______ I agree to use the vaporizer in accordance with provided instructions and in accordance with best practices of the use of oxalic acid vaporization on honey bees.
_______ I further agree this Release and Waiver of Liability shall be construed to be in accordance with the laws of the State of Iowa. By signing this Release and Waiver of Liability, I state that I have read and understand the conditions set forth, I agree to all conditions set forth, and I sign this voluntarily.
_______ This tool is only to be used for oxalic acid vaporization to treat for mites. Any other use is prohibited and may result in additional costs to the user.
Name______________________________________________
Signature________________________________________________ Date____________________
