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As a duly authorized representative of the Mobile Food Vendor listed below, I hereby agree to indemnify and hold harmless the City of Williamsport, PA and all of the Citys officers, representatives, employees, agents, instructors, volunteers, and/or other persons or entities acting for them arising out of, or resulting from any damages, injuries, or illness from any and all liability, including any injury to or death of any person, or damage to or destruction of property in or about the premises; defense costs, including attorney's fees and all other fees incidental to defense; loss or damage the City may suffer as a result of claims, demands, costs or judgments against it arising from any incident involving your Mobile Food Vendor's operation within the City of Williamsport, PA. 17701.
First Name *
Last Name *
Mobile Food Vendor Name
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I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign it of my own free will. This document is a binding agreement to release and waive legal claim. Applicant Signature:
