Laguna Hills Pep Squad Tryout Liability Release Form
Saddleback Valley Unified School District Waiver and Release Agreement - Assumption of Risk for Participation in a Voluntary High-Risk Activity
Due to our school closure, all participants will complete the “Tryout Liability Release Form” electronically in lieu of a handwritten copy.
Email *
Participant Name *
Age *
Parent/Guardian Name *
I hereby agree to participate in the described activity above. I realize that this activity is voluntary and is not a mandated requirement of the Saddleback Valley Unified School District curricular or extra-curricular program. The undersigned is specifically aware and confirms by executing this document that they are aware that participation in such an activity presents a higher than normal risk of bodily injury or wrongful death, and that the undersigned may injure himself or herself, or be injured by other participants related to the activity. *
Required
For and in consideration of my participation in the activity described above, the undersigned hereby voluntarily releases, discharges, waives and relinquishes any and all actions or causes of action for personal injury, bodily injury, property damage or wrongful death occurring or arising in any way whatsoever as a result of engaging in said activity or any activities incidental thereto wherever or however the same may occur and for whatever period said activities may continue. The undersigned does for him/herself, his/her heirs, executors, administrators and assigns hereby release, waive discharge and relinquish any action or causes of action, aforesaid, which may hereafter arise for him/herself and for his/her estate, and agrees that under no circumstances will he/she or his/her heirs, executors, administrators and assigns prosecute, present any claim for personal injury, bodily injury, property damage or wrongful death against the Saddleback Valley Unified School District, its Board, or any of its officers, agents, servants, or employees for any of said causes of action. *
Required
In the event of illness or injury, I give my permission to be treated by a physician. Please check one. *
Required
If “yes” was checked, in the event of illness or injury, I do hereby consent to whatever x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care and emergency transportation considered necessary in the best judgment of the attending physician, surgeon, or dentist and performed under the supervision of a member of the medical staff of the hospital or facility furnishing medical or dental services. I acknowledge that it will be my responsibility to pay for such medical/dental services. *
Required
Insurance Company *
Subscriber ID # *
The undersigned hereby acknowledges that he/she knowingly and voluntarily assumes all risks of bodily injury or wrongful death occurring or arising from the activity described above. I agree to exempt, relieve and hold harmless the District, its Board, officers, agents, and employees, from any claims for liability for personal injury, bodily injury, property damage or wrongful death that may arise out of or in any way be connected with the above-described activity. I have read the foregoing and have voluntarily signed this agreement. I am aware of the higher than normal risks involved in this activity and I am fully aware of the legal consequences of signing this instrument. *
Required
Please Type Parent Name for Electronic Signature *
Date Signed *
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Street Address *
City, State, Zip *
Home Phone Number *
Cell Phone Number *
In the event of an emergency, please contact *
Relationship of Emergency Contact *
Cell Phone of Emergency Contact *
A copy of your responses will be emailed to the address you provided.
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