PINE LAKES RANCH HOLD HARMLESS AGREEMENT

for

TOWING A STUCK/STRANDED MOTOR VEHICLE

Driver’s Legal Name:    _____________________________________________

D.L. or Identification #: _____________________________________________

Mailing Address:          ______________________________________________

                                      ______________________________________________

Pine Lakes Owner Name and Address (if not an owner – name of owner you are visiting):

PLR Owner/ visiting _______________________________________________

Phone #:     ___________________________License Plate #:__________________________

I, the above named driver, hereby agree to HOLD HARMLESS the operator of Pine Lakes Ranch equipment, Pine Lakes Ranch Homeowners Association, its agents and employees, from all possible damages, including death, injury and property damage for all acts or omissions in towing and pulling/pushing my stuck/stranded vehicle.  I also agree to PAY $50.00 to the Pine Lakes Homeowners Association within twenty-one (21) days from the signing of this document.  I further understand, if I fail to pay the $50.00 within 21 days, I will pay all costs and attorney fees associated with collecting said debt.  

Driver’s Signature __________________________      Date_________________, ________

Pine Lakes HOA Representative______________________________________

Remit $50.00 to:         Pine Lakes Homeowners Association

                                    1811 Pine Lakes Ranch Drive

                                    Cascade, ID  83611

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Remit $50 to:              Pine Lakes Homeowners Association

                                    1811 Pine Lakes Ranch Drive

                                    Cascade, ID  83611