TARA SUMMER YOUTH CAMP ABSOLUTE WAIVER, RELEASE, INDEMNITY AND COVENANT NOT TO SUE

(Minor Form To be signed by a parent or legal guardian having a child 20 years or younger)

The undersigned _______________________, as the parent and natural or legal guardian of ______________________ ("Minor Child"), desires to allow the Minor Child to participate in and attend the Tara Wildlife Summer Youth Camp ("Tara Camp") on property in Warren County, Mississippi (the "Property") owned by Purvis Grange Foundation, Inc. d/b/a Tara Wildlife, John C. 0. Bryant , Muddy Waters, L.L.C., or Tara Wildlife, Inc. (collectively "Tara"), subject to the terms, conditions and understandings set forth herein. The officers, directors, shareholders, members, agents and employees of Tara are collectively referred to as the "Indemnified Parties" and individually as an "Indemnified Party."

The undersigned recognizes that, among other activities, the Tara Camp curriculum involves instruction in firearm activities that can involve certain risks and dangers, and the undersigned desires to indemnify and hold the Indemnified Parties harmless from any such risks and dangers which may result to the Minor Child on or around the Property while attending the Tara Camp.

NOW, THEREFORE, for and in consideration of the right of the Minor Child to attend the Tara Camp and to participate in the activities therewith, including but not limited to archery, skeet, muzzleloaders, .22 rifles, and other firearms, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the undersigned, for himself, the Minor Child, his family, his heirs, administrators, executors, successors, devisees and assigns hereby agrees to and does hereby RELEASE, WAIVE, DISCHARGE, COVENANT NOT TO SUE, INDEMNIFY AND HOLD HARMLESS each Indemnified Party from and against all claims, demands, payments, suits, actions, recoveries, attorneys’ fees and judgments of whatsoever nature, kind and description, brought, recovered or extracted against any Indemnified Party for, or on account of, any loss, damage or injury (including death resulting therefrom) or any claim for loss, damage, injury or death received or sustained or alleged to have been received or sustained by the Minor Child on or around the Property while attending the Tara Camp.

I sign this instrument voluntarily, and with full knowledge and understanding of the rights I hereby waive and release. If any provision hereof is invalid or unenforceable, the other provisions shall remain in full force and effect, and the remaining provisions hereof shall be construed liberally in favor of each Indemnified Party in order to effectuate the provisions hereof. This agreement shall be governed by and interpreted in accordance with the laws of the State of Mississippi.

WITNESS THE SIGNATURE OF THE UNDERSIGNED, this the ___ day of ____________ 20

Witness _________________________________________

Printed Name _____________________________________

Name of Minor Child _______________________________