ACCIDENT WAIVER AND RELEASE OF LIABILITY
By agreeing to this Waiver, I assume all risk of my child and/or myself participating in
the above activity (hereinafter “activity”). Without signing this form, neither myself nor my
child will be able to participate in the activity. I acknowledge that the above activity may
pose some risk of personal injury and that I undertake and assume this risk for myself
and my child.
On behalf of myself and my child, I further waive and release the promoters of the
activity, school facility, any insuring entity of the above, and their directors, board
members, officers, employees, volunteers, agents, representatives, or assigns, as well
as the activity sponsors, from any and all liability, including, but not limited to, liability
arising from negligence or fault of the entities or persons for any injury or disability which
may occur as a result of my or my child’s participation in the above activity. I am assuming
all risks on behalf of myself and my child that may arise from negligence or carelessness
on the part of any of the persons or entities being released, as well as from defective
equipment, real property or personal property that is owned, maintained or controlled by
the above persons.
I CERTIFY THAT MY CHILD AND MYSELF ARE PHYSICALLY FIT AND
SUFFICIENTLY PREPARED FOR PARTICIPATION IN THE ACTIVITY AND THAT
THERE ARE NO HEALTH RELATED REASONS OR PROBLEMS WHICH WOULD
PRECLUDE THE PARTICIPATION OF MYSELF OR MY CHILD IN THE ACTIVITY. I
HAVE NOT BEEN ADVISED OF ANY REASON WHICH WOULD LIMIT MY CHILD OR
MYSELF IN PARTICIPATING IN THE ACTIVITY.
I consent to receive any medical treatment deemed advisable for an injury to
myself or my child during the activity and that any medical or other insurance for myself
and/or my child will be insurance of first resort before contribution by any other insurance
for any other person or entity, including accidental death and dismemberment insurance
and accident medical insurance.
I understand that I and/or my child may be photographed while participating in the
activity. I agree to allow my and my child’s photo, video, or film likeness to be used for
any legitimate purpose by the activity holders, sponsors, producers, and their assigns.
I shall defend, hold harmless, and indemnify the parties from and against all losses,
claims, damages, costs or expenses (including reasonable legal fees, or similar costs) in
connection with any action or claim brought or made (or threatened to be brought or
made), for, or on account of any injuries or damages, received or sustained by myself
and/or my child arising during the course of the activity.
This Agreement constitutes the sole and only agreement between the parties
concerning my child’s and my release and indemnification as a condition for participating
in this activity. Any prior agreements, whether oral or in writing, shall be void and of no
further effect. This Agreement may not be modified.
I certify that I have read this document, and I fully understand its contents. I am
aware that this is a release and indemnification of liability for myself and my child, and I
sign it of my own free will.