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    Waiver of Liability

    Uploaded by

    Cuisine Queens
    The document is a waiver of liability, assumption of risk, and indemnity agreement for participants in Dublin City Schools. It contains 6 sections: [1] It acknowledges risks of participation including injury and death. [2] It states the participant has no health problems precluding participation. [3] It agrees to reimburse the school for any litigation costs. [4] It voluntarily assumes all responsibility and risk of participation. [5] It agrees to abide by rules and that the school has no duty to provide medical services. [6] It releases the school from all liabilities and agrees not to sue for any injuries arising from participation.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Waiver of Liability

    Uploaded by

    Cuisine Queens
    57 views2 pages
    The document is a waiver of liability, assumption of risk, and indemnity agreement for participants in Dublin City Schools. It contains 6 sections: [1] It acknowledges risks of participation including injury and death. [2] It states the participant has no health problems precluding participation. [3] It agrees to reimburse the school for any litigation costs. [4] It voluntarily assumes all responsibility and risk of participation. [5] It agrees to abide by rules and that the school has no duty to provide medical services. [6] It releases the school from all liabilities and agrees not to sue for any injuries arising from participation.

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    Waiver of liability

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    The document is a waiver of liability, assumption of risk, and indemnity agreement for participants in Dublin City Schools. It contains 6 sections: [1] It acknowledges risks of participation including injury and death. [2] It states the participant has no health problems precluding participation. [3] It agrees to reimburse the school for any litigation costs. [4] It voluntarily assumes all responsibility and risk of participation. [5] It agrees to abide by rules and that the school has no duty to provide medical services. [6] It releases the school from all liabilities and agrees not to sue for any injuries arising from participation.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    57 views2 pages

    Waiver of Liability

    Uploaded by

    Cuisine Queens
    The document is a waiver of liability, assumption of risk, and indemnity agreement for participants in Dublin City Schools. It contains 6 sections: [1] It acknowledges risks of participation including injury and death. [2] It states the participant has no health problems precluding participation. [3] It agrees to reimburse the school for any litigation costs. [4] It voluntarily assumes all responsibility and risk of participation. [5] It agrees to abide by rules and that the school has no duty to provide medical services. [6] It releases the school from all liabilities and agrees not to sue for any injuries arising from participation.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    DUBLIN CITY SCHOOLS WAIVER OF

    LIABILITY, ASSUMPTION of RISK and


    INDEMNITY AGREEMENT for
    PARTICIPATING ADULTS and
    MINORS 

    In connection with and consideration of my participation on School premises, I, hereby represent


    and agree as follows:

    1. I am aware that participation in any activity on the School’s premises can potentially be
    dangerous, and I fully recognize and understand that there are risks and hazards, both
    minor and serious, associated with participation in the School, on the School’s premises
    and related activities, including, but not limited to: cuts, scrapes, bruises, broken bones,
    muscle strains, pulls or tears, head, neck, back, eye and other bodily injuries, heat
    exhaustion, heat stroke, frostbite, brain damage, blindness, deafness, drowning, heart
    attacks, paralysis and, even death.

    2. I represent and warrant that I have no physical, health related or other problems which
    would preclude or restrict my participation in the activity or otherwise render my
    participation dangerous or harmful to myself or others. I further represent and warrant
    that I have adequate medical, health, and/or other insurance coverage for participation.

    3. I further agree to reimburse or make good any loss or damage cost that the school (its
    officers, employees and agents) may have to pay if any litigation arises on account of any
    claim made by me or anyone on my behalf.

    4. Knowing the dangers, hazards and risks associated with the School and the specified
    activity and with sufficient knowledge of my physical condition(s) and limitations, if any,
    I voluntarily assume all responsibility and risk of loss, damage, illness and/or injury to
    person or property which I may, in any way, sustain in connection with participation in
    the School, on the School premises and related activities.

    5. I agree that I will abide by all rules and regulations applicable to participation in the
    activity and the School. I agree that the School, the School’s staff, or other person or
    entity involved in any way has no duty to provide medical services should I require
    emergency medical treatment or first aid as a result of illness or injury associated with the
    School or related and/or specified activities.

    6. To the fullest extent permitted by law, I hereby release and forever discharge, and agree
    not to sue and to indemnify and hold harmless, Dublin City Schools and their governing
    boards, officers, agents, employees and volunteers from and against any and all liabilities,
    claims, demands and causes of action of any kind, including litigation expenses and
    attorney’s fees on account of any loss, damage, illness or injury to person or property in
    any way arising out of or relating to my participation in or on ___Dublin Jerome High
    School____ premises, whether due to the negligence, mistake or other action or inaction
    of the School, the School’s staff, or other person or entity involved in any way with the
    School.

    THIS RELEASE CONTAINS AN INDEMNIFICATION CLAUSE. I CERTIFY THAT I


    HAVE READ AND FULLY UNDERSTAND THIS RELEASE, ASSUMPTION OF RISK
    AND INFORMED CONSENT FORM, AND I SIGN IT VOLUNTARILY WITH FULL
    KNOWLEDGE OF ITS SIGNIFICANCE.

    Student Name: ____________________________________________________

    Student Signature: ____________________________________________________

    Date: _______________________________

    If the student is a minor:

    Parent/Guardian Name: _______________________________________________

    Parent/Guardian Signature: _______________________________________________

    Date: _______________________________________________

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