Fill and Sign the Release Regarding Laboratory Activities Form

RELEASE The undersigned student desires to participate in a Lab to be held at the _____________ ______________________ (location) as part of the ________________________ to be held from the ___day of ________, 20___, to the ____day of ________, 20___, and to provide my own transportation to and from said Lab. In consideration of being allowed to participate in said Lab at said location, the undersigned does hereby release and discharge ___________________________, and all its officers, faculty members (including my instructor for said Lab), staff, officers, trustees, and employees from any all claims for damages for personal injury, death, or property damage which I may have, or which may subsequently accrue to me as a result of my participation in said Course and Lab and as a result of my travel to or from said Lab. This release is intended to discharge in advance ___________________ and all persons described above from and against any and all liability arising out of or connected in any way with my participation in said Course and Lab, and I hereby agree to assume all risks associated with this Course and Lab and to release and hold harmless ____________________ and all persons mentioned above who might otherwise be liable to me (or my heirs) for damages. It is further understood and agreed that this waiver, release, and assumption of risk is to be binding on my heirs and assigns. WITNESS my signature, this the ___ day of _______________, 20 ___. Print name:____________________________________ *Signature:_____________________________________ *( Must be signed by parents if under age 18 .)