Town of Sturbridge

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Conservation Commission

RELEASE FORM

I do hereby release the Town of Sturbridge Massachusetts, the Sturbridge Conservation Commission
and their employees and all agents from all claims, loss, damage, expenses and/or injuries which may
result from my volunteer activities on lands owned by the Town of Sturbridge.

I further agree to hold harmless the Town of Sturbridge Massachusetts, the Sturbridge Conservation
Commission and their employees and all agents from liability for damages or injuries resulting from
any acts or failure to act on my part my during my volunteer activities/participation on lands owned
by the Town of Sturbridge.

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Date Name

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Signature

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Parents Signature
(For participants who are under age eighteen)

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Address

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Town and zip

Town Hall 508-347-2506

308 Main Street (f) 508-347-5886
Sturbridge, MA 01566
The Town of Sturbridge is an Equal Opportunity Organization