Untitled Header Image Untitled Header Image Untitled Header Image
 

Insurance Waiver Adult

* indicates a required answer.

ADULT WAIVER AND RELEASE OF LIABILITY 2017-2018

In consideration of being allowed to participate in any way in South Coast Christian Home Educators related events and activities, the undersigned :

1. Agree that the member / participant should inspect the facilities and equipment to be used, and if the member / participant believes anything is unsafe, he or she should immediately advise  supervisor (advisor, manager, etc.) of such condition(s) and refuse to participate.

2. Acknowledge and fully understand that each member/participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence but the action, inaction, and negligence of others, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.

3. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.

4. Release, waive, discharge and covenant not to sue South Coast Christian Home Educators, its affiliated clubs, their respective administrators, directors, agents, and other employees of the organization, other members/participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors or premises used to conduct the event, all of which are hereinafter referred to as "releases" from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise.

I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY.

1. *

Name of Member / Participant :

2. *

Address of Member / Participant :

3. *

Telephone number of Member / Participant :

Get Another Captcha