(Please print this form)

In consideration of the Moore Academy Alumni Association, Inc. and participating landowners providing the premises for this benefit deer hunt, the undersigned hunters do hereby indemnify and hold harmless said Association and landowners from and against all liability for injury or damage to hunters and non-hunting guests resulting from the negligent or wanton acts or omissions of hunters or their non-hunting guests in exercising the rights granted under this benefit hunt.  Hunters further agree to defend and hold harmless the Association and participating landowners from any claim, action and/or judgment for damages to property or injury to persons suffered or alleged to be suffered on the premises.

IN WITNESS WHEREOF, the undersigned have set his/her hand and seal on this the _______________day of _________________, 2001.