RELEASE AND WAIVER: The undersigned understands that participation in Student-2-Student Program activities with American Indian Center of Houston may potentially expose students to activities and/or equipment which can lead to accidents and/or injuries. In consideration of Student’s acceptance into American Indian Center of Houston opportunities and programs, that the undersigned does hereby release, waive, discharge, indemnify, and hold harmless American Indian Center of Houston and its directors, officers, employees and agents, from and against any claim for damage, injury, loss or death to the above named student resulting from participation in any program or other activity either at American Indian Center of Houston or at another location, including any damage, loss or injury resulting from failure to abide by the “Conditions of Participation.” With a child’s registration in programs or activities, parent/guardian grants permission to take pictures and recordings of participants for publicity and promotional purposes (website, publications, etc.).

HEALTH CARE AUTHORIZATION: The undersigned hereby authorizes American Indian Center of Houston and its agents to perform any acts which may be necessary or proper to provide emergency health care of any student in the event that the Parent/Guardian cannot be reached, including consent to and authorization of medical procedures by physicians, dentists, hospital or other emergency medical personnel, as they, in the exercise of their sole discretion, may deem necessary. The undersigned understands that (s) he is responsible for all costs and expense of such medical treatment.

I HAVE READ THE ABOVE WAIVER AND RELEASE LIABILITY AND BY SIGNING, I AGREE THAT IT IS MY EXPRESS INTENT TO EXEMPT AND RELIEVE AMERICAN INDIAN CENTER OF HOUSTON AND ITS EMPLOYEES FROM LIABILITY FOR PERSONAL INJURY OR WRONGFUL DEATH OTHER THAN CLAIMS THAT ARISE AS THE DIRECT RESULT OF NEGLIGENCE. I CERTIFY THAT I HAVE FULL AUTHORITY TO SIGN THIS RELEASE AND AUTHORIZATION.