CAMPER REQUEST FORM

ACKNOWLEDGMENT & RELEASE

I acknowledge that I have voluntarily applied to receive a donation of a motorhome, recreational vehicle, trailer, or other donated goods (collectively referred to as “Donation”) from Americans Saving Americans, Inc. (ASA). I understand that this donation is being provided to me free of charge, and any associated costs such as repairs or transfer fees will be my responsibility.

As consideration for receiving this Donation, I, on behalf of myself, my assignees, heirs, legal representatives, and any other person or entity claiming through me, agree to release and hold harmless ASA, its legal representatives, donors, successors, assigns, and suppliers from any claims, lawsuits, or property attachment arising from injury or damage resulting from my use of the Donation, whether caused by negligence, intentional acts, or unintentional actions on my part.

I further release ASA and its representatives, donors, successors, and assignees from all claims, actions, or demands, whether present or future, that may arise from my participation in this program. This release extends to any injuries or damages related to the donation, transfer, or participation in ASA activities.

I understand and agree that this Release is intended to be as broad and inclusive as permitted by the laws of the United States of America. In the event that any provision is found to be invalid by a court of competent jurisdiction, the remaining provisions shall continue to be in full force and effect.

I acknowledge the risks of injury, including death, associated with the use of the Donation, and I voluntarily assume these risks by signing this agreement.

If any violation of this agreement results in a lawsuit or claim against ASA, I agree to indemnify and hold ASA and all other entities named in this agreement harmless from any costs, expenses, or liabilities, including but not limited to attorney fees, related to such action.

I hereby grant ASA, its legal representatives, successors, and assigns permission to take, copyright, and use photographic portraits, pictures, or similar images or likenesses (collectively referred to as “Pictures”) of me and my children and/or property for any purpose, including but not limited to illustration, promotion, advertising, or any other lawful use in any medium and format.

I agree to hold harmless ASA and its representatives from any liability arising from the use of these Pictures.

I affirm that I am 18 years of age or older and that I am fully competent to sign this agreement on my own behalf. I acknowledge that I have read and fully understand the contents of this document.