Davis Phoenix Coalition Youth Group RSVP Form  
HEALTHY RELATIONSHIPS 
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If we contact you by phone, should we be discrete?
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Are you coming to our self-defense class on December 4th at 6pm *

Queer Youth Healthy Relationship Waiver, Release, Hold Harmless, and Indemnification Agreement

As Consideration for being allowed to participate in a presentation of Healthy Relationships, the undersigned, on their behalf, and on the behalf of the Participant(s) identified, acknowledges, appreciates, understands, and agrees to the following:

I represent that I am the parent or legal guardian of the minor Participant(s) named or I have obtained permission from the parent/legal guardian of the Participant(s) named to execute this agreement on their behalf.

I agree that the Participant(s) named, and I shall comply with all stated and customary terms, rules, and verbal instructions as conditions for participation in any part of the area.

I, for myself, the Participant(s) named, our heirs, assigns, representatives, and next of kin agree to hold harmless and indemnify The Phoenix Coalition, their predecessors, parent, subsidiaries and affiliates, officers, and employees from any and all injuries, liabilities or damages from participation.

I am of physical ability to participate and am legally competent to understand and complete this agreement.  I hereby execute this agreement without coercion.

By signing below I acknowledge that I agree to the content of the waiver/agreement, intending to be legally bound, for myself, my heirs, my executors and administrators, waive and release any and all rights and claims for damages I may have against the queer teen healthy relationship class and their representatives, successors. I attest that I will participate in this event as a healthy relationship course.
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ARE YOU EXCITTTTTEDDD????? 
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