Long Home President's Club

Spouse/Guest Information

If your spouse or a guest is accompanying you on the trip, complete the full name and DOB for your spouse/guest below.

If no spouse or guest, simply put “NA” in the name fields and put today’s date for their DOB.

TERMS AND CONDITIONS: I have voluntarily agreed to participate in or have otherwise accepted, a vacation or trip which has been sponsored by, awarded by or otherwise provided to me by Long Fence and Home, LLLP. I am aware that during the trip or vacation, certain risks and dangers may arise, including, but not limited to, the hazards of traveling away from home, illness or accident in remote places without immediate access to medical facilities, the forces of nature, and travel by air, bus, automobile or other means of transportation, as well as risks inherent in any activities in which I may choose to participate during this trip or vacation. I understand that I am not required to accept or otherwise participate in this trip or vacation, and that I do so voluntarily. In consideration of, and as part payment for, the right to participate in this trip or vacation and any activities and services during this trip or vacation that I partake of, I hereby for myself and my successors, agents, servants, associates, attorneys, insurers, predecessors,assigns, heirs, personal representatives, administrators, executors, and legal representatives,expressly release, acquit and forever discharges, and covenant not to sue, Long Fence & Home,LLLP, its agents, parents, affiliates, subsidiaries, officers, directors, or otherwise, as well as their heirs, personal representatives, administrators, executors, beneficiaries, insurers, agents, attorneys, employers and assigns of and from any and all claims and demands of whatever nature, action and causes of action, damages, punitive damages, counsel fees, bodily injury, death or loss of personal property and expenses, costs, and compensation of any kind known to law or equity, resulting directly or indirectly from my participation in this trip or vacation or any transactions, causes, acts done or activities undertaken during such trip or vacation. I certify that I am fully capable of participating in this trip or vacation and any activities I partake of during this trip or vacation. Therefore, I assume and accept full responsibility for myself for bodily injury, death, or loss of personal property and expenses as a result of these inherent risks and dangers identified herein and those inherent risks and dangers not specifically identified, and as a result of my negligence or the negligence of any agent or employee of Long Fence & Home, LLLP. I understand that I am to be fully responsible for any medical treatment and/ or necessary emergency evacuation resulting from my participation om this trip or vacation. Should any portion of this agreement be held invalid, I agree that the balance of the agreement will continue in full legal force and effect. I have carefully read, clearly understood, and accepted the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon myself, my heirs, assigns, personal representatives, and estate and for all members of my family, including minor children.