Education Class Waiver

Education Class Waiver

Student Information

Date of Birth:    Student ID:

Parent / Guardian (If Student Is a Minor)

If the student is under 18 years of age, a parent or legal guardian must complete the following information and sign the waiver on behalf of the minor.

Relationship to Student:    Phone:

Class Information

Class Code:    Instructor:

Class Dates:    Location:

Emergency & Medical Information

Relationship:    Phone:

Waiver, Assumption of Risk, and Release

I, the undersigned, on behalf of myself and my heirs, assigns, personal representatives and next of kin, acknowledge that participation in the class identified above may involve inherent risks, including but not limited to physical injury, illness, property damage, and other losses. I expressly assume all risks associated with participation, whether known or unknown, foreseeable or unforeseeable.

In consideration for being permitted to participate, I hereby release, waive, discharge and covenant not to sue the educational institution, its trustees, officers, employees, agents, volunteers and instructors (collectively, the Institution) from liability for any and all claims, demands, losses, damages, or causes of action arising from my participation, including claims arising out of the negligence of the Institution to the fullest extent permitted by law. I agree to indemnify and hold the Institution harmless from any claim, suit, loss or expense, including reasonable attorneys' fees, that arises from my participation or from my breach of this Waiver.

I understand that this Waiver includes, but is not limited to, claims based on negligence, action or inaction of the Institution, and any negligent rescue operations; it is intended to be as broad and inclusive as permitted by applicable law. If any portion of this Waiver is held invalid, I agree that the remaining portions shall continue in full legal force and effect.

Medical Authorization

I authorize authorized representatives of the Institution to obtain and consent to emergency medical care and treatment for the student named above in the event of injury or illness if I cannot be reached. I understand that I am financially responsible for all costs associated with such medical care and treatment.

Media Release

Photos, video, or audio recordings may be taken during class activities for educational or promotional purposes. Please indicate your permission choice below.

  I grant permission for use of my or my child's image/audio for institutional publications and educational materials.
  I do NOT grant permission for use of my or my child's image/audio.

Policies & Acknowledgements

I acknowledge that I have read, understand and will comply with the Institution's safety rules, code of conduct, attendance and refund policies applicable to this class. I understand that failure to comply may result in removal from the class without refund where permitted by policy.

  I acknowledge and accept the above policies and conditions.

Consent for Minor (if applicable)

By checking the box below and signing this Waiver, the parent or legal guardian confirms they are authorized to consent on behalf of the minor student and agree to be bound by the terms of this Waiver.

  I am the parent or legal guardian of the student named above and I consent to the terms of this Waiver on behalf of the minor.

Certification

I certify that the information provided on this form is true and correct to the best of my knowledge, and that I have the authority to sign this document. I understand that signing this Waiver affects my legal rights and that I should not sign it unless I have read it fully and understand its contents.

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