Accident Waiver And Release Of Liability Form (Page 3 of 3) in pdf

Accident Waiver And Release Of Liability Form Page 3

PARENT / GUARDIAN CONSENT & WAIVER FOR MINORS (Under 18 years old)

The undersigned parent and/or legal guardian does hereby represent that he/she is, in fact,

acting in such capacity, has consented to his/her child or ward’s participation in the activity

or event, and has agreed individually and on behalf of the child or ward, to the terms of the

accident waiver and release of liability set forth above. The undersigned parent, guardian, or

individual further agrees to save, defend, hold harmless and indemnify each and all of the

parties released above from all liability, loss, cost, claim, or damage whatsoever which may

be imposed upon said parties because of any defect in this parental/guardian consent and

waiver caused or occasioned by the undersigned, or for any lack of capacity of the

undersigned to act in consenting and waiving the released parties on behalf of the minor and

the parents or legal guardian thereof.

________________________________/ _______/ _________________________________

Print Participant’s Name

Age

Print Name of Parent or Guardian

________________________________

Dated:_______________, 2016

Signature of Parent or Guardian

Civic Ballet of San Luis Obispo Accident Waiver and Release of Liability - 3

Accident Waiver And Release Of Liability Form Page 3