SAKA LOGO Southern Arizona Koi  Association

Supply Stations

Hold Harmless Agreement

I , the undersigned a member of the Southern Arizona Koi Association Inc, a non profit corporation, hereafter referred to as SAKA, and owner of a personal koi pond, herein referred to as "Owner" understand and accept that the person/persons providing me emergency supplies for my personal koi is/are not a licensed veterinarian nor in any manner a professional related to koi. Owner has requested the assistance with obtaining emergency supplies for Owner’s personal koi.

Owner hereby acknowledges that knowing the volume of his/her pond system is critical when calculating and adding substances to the pond system. Owner acknowledges that he/she has researched the problems in his/her pond and has determined the proper emergency supplies needed and the proper dosage amounts based on his/her pond volume to resolve said problem. Owner is responsible for all mathematical calculations to determine the total amount, in grams or teaspoons of supplies needed. Attendants of the Emergency stations are NOT Veterinarians, Pharmacists, or Chemists.

Owner agrees to indemnify and hold harmless SAKA, all those associated with the SAKA, including its officers, directors, members and Emergency Supply Station Attendants from all damages, miscalculations, claims, losses, expenses, fees, including attorney’s fees, costs and judgments that may be asserted against the aforementioned that may result from any actions either directly or indirectly resulting from the calculations and administration of any emergency supplies obtained from the SAKA Koi Emergency Stations, including assistance and/or advice or lack there off

Owner will provide a donation; equal to the cost of all emergency supplies Owner requests and is provided by SAKA.

By signing this Agreement below, Owner agrees that Owner understands and accepts the terms and conditions of this Agreement, which shall be the sole and entire agreement between the Owner and the Southern Arizona Koi Association Inc and all other parties associated with the SAKA Koi Emergency Station program.


Signed,______________________________________ Date:___________________

Owner Name _________________________________________________________

Supply requested _____________________ Amount requested/received ______________


 Donation Amount  $________


I accept            I decline


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