TAMPA BAY HARVEST

RELEASE, INDEMNITY AND HOLD HARMLESS AGREEMENT

This RELEASE, INDEMNITY AND HOLD HARMLESS AGREEMENT, ("Release") executed as of the ______ day of ________________ 20___, by _________________________________________ a, __________________________________________________________ ("Recipient") in favor of TAMPA BAY HARVEST, INC., a Florida Corporation Not For Profit, ("TBHI") and referred to jointly with Recipient as either Party or Parties.

WHEREAS, Recipient operates a facility that functions in part, to feed hungry persons that might not otherwise have readily available food;

WHEREAS, TBHI operates to locate and deliver or arrange for the delivery of food that might otherwise be discarded to facilities such as that operated by Recipient;

WHEREAS, TBHI has agreed to arrange for the donation and delivery or to arrange for the delivery from time to time of certain food items (the "Food") which will be donated to Recipient;

WHEREAS, Recipient acknowledges that TBHI would not have arranged for the donation and delivery of or delivered the Food and that the TBH donor would not have donated the Food but for the execution of this Release by Recipient; and,

WHEREAS, as an inducement and condition to TBHI to arrange for the donation and delivery of or deliver the Food, Recipient has agreed to execute this Release in the form hereinafter set forth.

NOW THEREFORE, for and in consideration of having the Food delivered by TBHI, Recipient, on behalf of itself and its successors, subsidiaries, principals, agents, representatives, employees, members, assigns, guests, clients, customers and invitees (all hereinafter collectively referred to as the ("Releasing Party") does hereby release, discharge, and forever relinquish TBHI and its subsidiaries, principals, agents, representatives, partners, and officers, past or present employees, agents, members, and directors, all persons for whom they could be vicariously liable, and all successors and assigns, (all hereinafter collectively referred to as the ("Released Parties") and agrees to assume responsibility for, and to indemnify, defend and hold harmless the Released Parties, from and against any and all liability, loss, costs, and expenses, including, but not limited to, attorneys' fees, claims, suits and judgments of every kind and nature, including third party claims for indemnity, contribution, and other cause of action, whether in connection with any injury to, or death of , any person or persons or loss of or damage to any party resulting from or in any way whatsoever connected with the Releasing Party's or anyone else's consumption of the Food or carrying out of any activities in connection with the donation and delivery of the Food, whether such injury, death, loss or damage results from the partial or sole negligence of the Released Party.

DATED this______ day of ______________, 20____.

Name of Recipient Agency: _________________________________________________________

Type of Operation: ____________________________________________________

Authorized Signatory:

By: ____________________________________________________

Title___________________