I want to swim in Lake Cane.  I would like to enter and vacate Lake Cane from the Meisenheimer residence.  The Meisenheimers would like to allow me to swim in the lake, but are afraid that I or someone on my behalf might sue them if I am injured or die as a result of swimming in the lake. I understand that there are no lifeguards, nobody on rescue craft, in fact there are no safety features at all.  I understand that the water is deep and that I will not be able to touch the bottom.  I understand that there are many other swimmers who will be swimming and that those other swimmers present a danger to me.  In spite of all of this – and in spite of any other danger imaginable – I want to swim in this lake.

In order to let me swim in the lake, the Meisenheimers have asked me to sign this participant agreement, release and assumption of risk document.  By signing this agreement – and in fact prior to ever signing this agreement – I am acknowledging that I understand that I am voluntarily assuming all risks associated with swimming in the lake.    In consideration of being allowed to swim in Lake Cane I hereby agree to release, indemnify, and discharge Lucky Meisenheimer a/k/a John Meisenheimer, Jr. , Jacquie Meisenheimer, John Meisenheimer VII, Jake Meisenheimer, Maximus Meisenheimer, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:

(1) I acknowledge that my participation in swimming in the lake entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: drowning, near-drowning, having a muscle cramp and drowning, or near drowning, being trampled, struck, and pushed underwater by other swimmers (in fact one of the reasons I like this swim so much is because there are so many swimmers), getting tired or exhausted and then drowning or near drowning, discovery of some unknown medical problem during or after the swim which cause some injury/death. Injury/death caused by the negligence of some other participant, amoeba or bacteria getting inside me, being attacked or injured by animals domestic/wild in or around the lake, being run over by a boater or some other personal watercraft, swimming into a floating or fixed object in the lake.  I understand that I could panic and drown (even if I have swum long distances or in crowded circumstances many times before), someone else could panic and drag me under.  I further understand that these risks include all risks associated with weather conditions such as heavy rain and lightning.  Fog could roll in and disorient me. Swimming in the dark could disorient me.  Waves could be stirred up and cause panic by me and/or others.  Extremes in water temperature could potentially cause hypothermia or hyperthermia with disorientation/injury/death. I also understand that the Meisenheimers could themselves be negligent and cause me injury and/or death.

(2) I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.

(3) I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the Meisenheimers from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Lake Cane or the Meisenheimers’ home or property, including any such claims which allege negligent acts or omissions of the Meisenheimers and/or anyone on their behalf


(4) Should the Meisenheimers or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

(5) I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.

(6) In the event that I or anyone on my behalf or my estate files lawsuit against any of the Meisenheimers, I agree to do so solely in the state of Florida, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect.

By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against any of the Meisenheimers on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.


I acknowledge that when I have signed this form once, it will apply every time I wish to swim in the lake. 


Signature of Parent, Legal Guardian, or Participant:


Print Name: _____________________________________ Relationship to Participant(s):


PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (Must be completed for participants under the age of 18)

In consideration of the below printed minor(s) name(s) being permitted by the Meisenheimers to participate in swimming in Lake Cane I further agree to indemnify and hold harmless the Meisenheimers from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.

Minor Name ______________________________________ Please print.