STUDENT LIABILITY WAIVER AND RELEASE OF CLAIMS

ORGANIZATION INFORMATION

[ORGANIZATION NAME] ("Organization")

Address: [ADDRESS]
Phone: [PHONE]
Email: [EMAIL]

PARTICIPANT INFORMATION

Student/Participant

Parent/Guardian (if Student is under 18)

ACTIVITY/PROGRAM INFORMATION

Program/Activity Name: [PROGRAM NAME]

Activity Description: [DESCRIBE ACTIVITIES]

Date(s): [DATE(S) OR RANGE]

Location(s): [LOCATION(S)]

SECTION 1: DESCRIPTION OF ACTIVITIES

The activities covered by this Waiver include, but are not limited to:

☐ Classroom instruction and educational activities
☐ Tutoring sessions
☐ Physical education and recreational activities
☐ Arts and crafts activities
☐ Science experiments and laboratory activities
☐ Field trips and off-site activities
☐ Sports and athletic activities
☐ Swimming and water activities
☐ Outdoor activities (hiking, camping, etc.)
☐ Performance and theatrical activities
☐ Music instruction and practice
☐ Transportation to/from activities
☐ Use of equipment, tools, and materials
☐ Other: [SPECIFY]

SECTION 2: ACKNOWLEDGMENT OF RISKS

2.1 Understanding of Risks

I understand and acknowledge that participation in educational and recreational activities involves inherent risks that cannot be eliminated regardless of the care taken by the Organization. These risks include, but are not limited to:

General Risks:
☐ Slips, trips, and falls
☐ Bumps, bruises, and minor injuries
☐ Sprains, strains, and muscle injuries
☐ Cuts, scrapes, and abrasions
☐ Exposure to communicable illnesses
☐ Allergic reactions
☐ Emotional stress or anxiety

Activity-Specific Risks:
☐ Sports injuries (fractures, concussions, etc.)
☐ Water-related risks (drowning, injuries)
☐ Equipment-related injuries
☐ Injuries from other participants
☐ Weather-related risks (heat, cold, sun exposure)
☐ Transportation accidents
☐ [OTHER SPECIFIC RISKS]

Serious Risks:
☐ In rare cases, participation may result in serious injury, permanent disability, or death
☐ These risks exist despite reasonable safety measures

2.2 Voluntary Participation

☐ I understand that participation in these activities is completely voluntary
☐ I have chosen to participate with full knowledge of the risks involved
☐ I am not being forced or coerced to participate

SECTION 3: ASSUMPTION OF RISK

I KNOWINGLY AND VOLUNTARILY ASSUME ALL RISKS associated with participation in the activities described herein, whether identified above or not.

I understand that:
☐ Accidents and injuries can occur even when all safety precautions are followed
☐ The Organization cannot guarantee a risk-free environment
☐ I (or my child) may be exposed to risks from the conduct of other participants
☐ Conditions may change unexpectedly

By signing this Waiver, I assume full responsibility for any injury, loss, or damage suffered during participation, to the extent permitted by law.

SECTION 4: WAIVER AND RELEASE OF LIABILITY

4.1 Release of Claims

I, the undersigned, on behalf of myself, my minor child (if applicable), and our heirs, executors, administrators, and assigns, hereby:

RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE:

[ORGANIZATION NAME], including its:
☐ Owners, officers, directors, and trustees
☐ Employees, instructors, and staff
☐ Volunteers and agents
☐ Affiliates and partners
☐ Insurers
☐ Successors and assigns

(collectively, "Released Parties")

4.2 Scope of Release

This release covers any and all claims, demands, causes of action, judgments, and liabilities of any kind arising out of or related to:

☐ Participation in the activities described
☐ Use of Organization's facilities, equipment, or premises
☐ Transportation provided by or arranged by Organization
☐ Acts or omissions of Released Parties
☐ Acts or omissions of other participants
☐ Conditions of premises or equipment
☐ Emergency response or medical treatment

This release applies to claims based on:
☐ Negligence of the Released Parties
☐ Breach of duty
☐ Premises liability
☐ Any other legal theory (except gross negligence or intentional misconduct)

4.3 Types of Damages Released

This release covers all types of damages, including:
☐ Personal injury
☐ Death
☐ Property damage or loss
☐ Medical expenses
☐ Pain and suffering
☐ Emotional distress
☐ Any other damages

SECTION 5: INDEMNIFICATION

I agree to INDEMNIFY, DEFEND, AND HOLD HARMLESS the Released Parties from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney's fees, arising from:

☐ My (or my child's) participation in the activities
☐ My (or my child's) conduct during activities
☐ Any breach of this Waiver
☐ Any misrepresentation in this Waiver
☐ Claims by third parties arising from my (or my child's) participation

SECTION 6: MEDICAL AUTHORIZATION

6.1 Emergency Medical Treatment

☐ In case of injury or medical emergency, I authorize the Organization to obtain emergency medical treatment for me (or my child)
☐ I authorize emergency medical personnel to provide treatment as necessary
☐ I authorize transport to a medical facility if needed
☐ I agree to be responsible for all medical costs not covered by insurance

6.2 Medical Information

☐ I have disclosed all relevant medical conditions, allergies, and medications
☐ I will notify Organization of any changes to medical status
☐ I understand the importance of accurate medical information

6.3 Insurance

☐ I understand my personal/family insurance is primary coverage
☐ Organization's insurance (if any) is secondary/excess only
☐ I am responsible for maintaining adequate insurance coverage

SECTION 7: PARENT/GUARDIAN PROVISIONS

7.1 Authority to Bind Minor

If signing on behalf of a minor child:

☐ I am the parent or legal guardian of the minor named above
☐ I have full legal authority to sign this Waiver on behalf of the minor
☐ I agree to all terms of this Waiver on behalf of myself and the minor

7.2 Binding Effect on Minor

☐ I intend this Waiver to be binding on myself and the minor to the fullest extent permitted by law
☐ I understand that in some jurisdictions, waivers signed on behalf of minors may have limited enforceability
☐ I agree to indemnify the Released Parties for any claims brought by or on behalf of the minor

7.3 Parental Supervision

☐ I understand my responsibility for my child's conduct
☐ I have discussed the risks and expectations with my child
☐ I have determined that participation is appropriate for my child

SECTION 8: RULES AND CONDUCT

8.1 Agreement to Follow Rules

I agree (and agree on behalf of my child) to:

☐ Follow all safety rules and guidelines
☐ Follow all instructions from staff and supervisors
☐ Use equipment properly and only as directed
☐ Immediately report any unsafe conditions
☐ Refrain from conduct that endangers self or others
☐ Leave premises or activities if asked to do so

8.2 Consequences of Violation

☐ I understand that failure to follow rules may result in removal from activities
☐ No refunds will be provided for removal due to rule violations
☐ I remain liable for any damages caused by my (or my child's) conduct

SECTION 9: ADDITIONAL ACKNOWLEDGMENTS

9.1 Physical Condition

☐ I (or my child) am physically capable of participating in the activities
☐ I have consulted a physician if there are any concerns about participation
☐ I will notify Organization of any physical limitations

9.2 Personal Belongings

☐ Organization is not responsible for lost, stolen, or damaged personal belongings
☐ I will not bring valuable items to activities

9.3 Photography/Recording

☐ I understand that activities may be photographed or recorded
☐ See separate Photo/Video Release form if applicable

9.4 Insurance Recommendation

☐ I understand that adequate insurance is recommended
☐ I have been advised to consider additional coverage if appropriate

SECTION 10: GOVERNING LAW AND LEGAL TERMS

10.1 Governing Law

This Waiver shall be governed by and construed in accordance with the laws of [STATE], without regard to conflicts of law principles.

10.2 Venue

Any legal action arising from this Waiver shall be brought exclusively in the courts of [COUNTY, STATE].

10.3 Severability

If any provision of this Waiver is found to be invalid or unenforceable, the remaining provisions shall continue in full force and effect.

10.4 Entire Agreement

This Waiver, together with any enrollment or participation agreement, constitutes the entire agreement between the parties regarding the subject matter hereof.

10.5 Modification

This Waiver may not be modified except in writing signed by both parties.

10.6 Waiver of Breach

Failure to enforce any provision shall not constitute a waiver of future enforcement.

SECTION 11: CERTIFICATION AND SIGNATURE

11.1 Acknowledgments

By signing below, I certify that:

☐ I have carefully read this entire Waiver and fully understand its contents
☐ I am aware that this Waiver releases the Organization from liability
☐ I am aware that this Waiver includes an assumption of risk
☐ I am signing this Waiver voluntarily and of my own free will
☐ No representations or statements have been made that are not in this Waiver
☐ I understand I am giving up substantial legal rights
☐ I have had the opportunity to ask questions
☐ I have had the opportunity to consult with an attorney

11.2 Age Verification

☐ If signing as a participant: I am at least 18 years of age
☐ If signing for a minor: I am the parent or legal guardian of the minor

SIGNATURES

Adult Participant (18+)

Signature: _________________________________ Date: _____________

Printed Name: _________________________________

Parent/Guardian (for Minor Participants)

Signature: _________________________________ Date: _____________

Printed Name: _________________________________

Relationship to Minor: _________________________________

Minor's Full Name: _________________________________

Minor's Date of Birth: _________________________________

WITNESS (Optional but Recommended)

Signature: _________________________________ Date: _____________

Printed Name: _________________________________

Address: _________________________________

EMERGENCY CONTACT INFORMATION

MEDICAL INFORMATION (Brief)

Allergies: _________________________________

Medical Conditions: _________________________________

Medications: _________________________________

Physician: _________________ Phone: _____________

This Student Liability Waiver template is provided for informational purposes only and does not constitute legal advice. Consult with a qualified attorney in your jurisdiction before use. The enforceability of liability waivers varies significantly by state and is particularly limited for waivers signed on behalf of minors. Some states do not enforce parental waivers for children's activities.