Waiver of Liability Form

I hereby acknowledge that I am eighteen (18) years of age or older, can read the English language or have had a person I trust to read this form aloud to me, and further acknowledge and agree, follows:

1. I acknowledge by electronically signing below that I am VOLUNTARILY requesting that the Solid Waste and Recycling Center deliver a trailer to the address designated herein.
2. I acknowledge that it is my responsibility to prevent my children or other minors on the premises of the designated address to avoid any and all contact, directly or indirectly, with the trailer.
3. I hereby release the Solid Waste and Recycling Center and the Mississippi Band of Choctaw Indians and their employees, agents, departments, and other entities from any and all liability related to or arising from my request for delivery of a trailer by Solid Waste and Recycling Center. This means that I waive the right to bring any claim or lawsuit in any court under any theory of law based on or arising from this action including, but not limited to, any injury arising from: placing an item in, or removing an item from the trailer; making physical contact with the trailer, whether directly or indirectly; the trailer rolling or otherwise moving while on the designated property, and slips/falls from any surface of the trailer. THIS LIST OF POTENTIAL CAUSES OF INJURIES IS MEANT TO BE DEMONSTRATIVE, BUT NOT ALL-INCLUSIVE.
4. This waiver and release includes claims based on allegations of negligence by agents, employees, and any other persons acting on behalf of the Solid Waste and Recycling Center and the Mississippi Band of Choctaw Indians in any manner related to the delivery of the trailer, contact or any other interaction with the trailer while on the designated property, and the retrieval/removal of the trailer from the designated property.
5. This waiver and release shall be interpreted under the laws of the Mississippi Band of Choctaw Indians. The Choctaw Tribal Court is the exclusive jurisdiction in the event of litigation.