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When recorded mail to: ______________________________ ______________________________ ______________________________ HOLD HARMLESS AGREEMENT Effective Date: County and State: FIRST PARTY (Name, Address & Zip Code): SECOND PARTY (Name, Address & Zip Code): Activity, Contract, or other Legal Instrument: Duration of Activity or Date: Scope of Agreement This Agreement is mutual and through it each party holds the other harmless and releases the other from all liability arising from the activity involved. This Agreement is unilateral and through it: First party holds Second party Second party holds First party harmless and releases him/her from all liability arising from the activity involved. When Release Is Effective It is contemplated that the parties may execute this release at different times for convenience sake; however, this release shall not be effective until after all parties, or their lawful agents, have executed the release, then its effective date shall revert back to the date which has been set forth above. Additional Provisions: -1- In witness whereof the parties have executed this intending it to be effective on the above effective date. Signature of the First Party STATE OF County of Signature of the Second Party ) )ss ) Subscribed and Sworn before me this _____ date of ____________________________, 20_____ by _____________________________________________________ Notary Public _____________________________________ ( seal ) STATE OF County of ) )ss ) Subscribed and Sworn before me this _____ date of ____________________________, 20_____ by _____________________________________________________ Notary Public _____________________________________ ( seal ) -2-

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