__ I HAVE RECEIVED THE SAFETY ORIENTATION/RULES 2208 Edwards Ave, El Monte, CA 91733 |
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RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND
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| ___________________________________ Printed name of participant |
___________________________________ Today's Date |
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| ___________________________________ Signature of Participant |
___________________________________ Date of Birth |
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| ____________________________ E-mail Address |
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PARENTAL CONSENT AND I, the minor’s parent and/or legal guardian, understand that nature of the above referenced activities and the Minor’s experience and capabilities and believe that minor to be qualified to participate in such activity. I hereby Release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releases from all liability, claims, demands, losses or damages on the minor’s account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the minor, or anyone on the minor’s behalf makes a claim against any of the above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasee may incur as a result of any such claim. |
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| ___________________________________ Printed name of Parent/Legal Guardian |
___________________________________ Date |
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| ___________________________________ Signature of Parent/Legal Guardian ___________________________________ E-mail Address |
___________________________________ Phone ___________________________________ Address ___________________________________ City, State, Zip |
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