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Field Trip Permission Hold Harmless Form

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Field Trip Permission/Hold Harmless Form

In consideration of permission granted by ______________ allowing me to participate

in _______________________________________________ (the "Activity"), which will occur

on _________________, which is sponsored by _________________________________, I

(together with my parent or guardian, if I am under the age of eighteen or under a legal

disability) represent, covenant and agree, on behalf of myself and my heirs, assigns, and any

other person claiming by, under or through me, as follows:

I acknowledge that participating in the Activity involves certain risks (some of

which I may not fully appreciate) and that injuries, death, property damage or other harm could

occur to me or others. I accept and voluntarily incur all risks of any injuries, damages, or harm

which arise during or result from my participation in the Activity, regardless of whether or not

caused in whole or in part by the negligence or other fault of ________________,

of _________________, and/or its or their departments, trustees, affiliates, employees, officers,

agents or insurers ("Released Parties").

I waive all claims against any of the Released Parties for any injuries, damages,

losses or claims, whether known and unknown, which arise during or result from my

participation in the Activity, regardless of whether or not caused in whole or part by the

negligence or other fault of any of the Released Parties. I release and forever discharge the

Released Parties from all such claims.

I agree to indemnify and hold the Released Parties harmless from all losses,

liabilities, damages, costs or expenses (including but not limited to reasonable attorneys' fees

and other litigation costs and expenses) incurred by any of the Released Parties as a result of

any claims or suits that I (or anyone claiming by, under or through me) may bring against any

of the Released Parties to recover any losses, liabilities, costs, damages, or expenses which

arise during or result from my participation in the Activity, regardless of whether or not caused

in whole or part by the negligence or other fault of any of the Released Parties.

I have carefully read and reviewed this Waiver, Release And Hold Harmless

Agreement. I understand it fully and I execute it voluntarily.

EXECUTED this __________ day of __________________, 20______.

______________________

___________________

Student Signature

Student’s Printed Name

____________________________________

_______________________

Parent or Guardian Signature (if applicable)

Parent/Guardian Printed Name

Field Trip Permission Hold Harmless Form

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