FSB Connect Club

Activity Participation Agreement and Release
This agreement will be in place for the Calendar Year 2019


In consideration of my participation in the Connect Club activity (“Activity”) sponsored by Farmers State Bank (“FSB”), I expressly agree and contract, on behalf of myself, my family, heirs, executors, administrators, successor and assigns, that FSB and its insurers, employees officers, directors, and associates shall not be liable for any damages arising from personal injuries or property loss sustained by me as a result of my decision to attend and participate in such Activity


I acknowledge and understand that FSB may engage various tour operators and other organizations as independent contractors to provide the accommodations, transportation and other services offered as part of the Activity.  By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages and losses of any type, which may occur to me, and I hereby fully and forever release and discharge FSB, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out my attendance and participation in the Activity. 


I agree to comply with all rules imposed by FSB for my participation in the Activity.  I agree to conduct myself in a controlled and reasonable manner at all times, to follow all safety rules imposed by any third parties, and to refrain from engaging in any dangerous, harmful, illegal, or destructive conduct.  I understand and agree that FSB is not responsible for property that is lost, stolen, or damaged during or as part of the Activity.


I also agree to allow FSB the use of any photos from a trip to be used for advertising purposes.


I also understand that I must be physically and mentally able to participate in all stated itinerary items.  Any person who cannot travel independently or needs special assistance must be accompanied by a family member who will be able to assist and assume responsibility for this person.  FSB reserves the right to decline participation on any tour in which the participant’s capabilities are determined by FSB’s Connect Club to not meet the needs of the tour.  Neither FSB personnel nor its suppliers may assist with medications or physically aid participants on the tours.  Special dietary requirements must be indicated at the time of the reservation and every effort will be made to accommodate the request; however no guarantees can be made that venues will be able to accommodate the request.


FSB has the right to substitute services of comparable quality if the advertised services become unavailable. 


FSB will issue a full refund of all monies made if cancellation is received by phone or in writing to the Farmers State Bank Connect Club Director prior to the final payment due date.




Signature:  _______________________         Signature: __________________________


Printed Name(s): _______________________                  __________________________  


Date:   Sunday, June 30th – Wednesday, July 3, 2019


Tour:   Ballard’s Resort Fishing Trip