MARCHING BEARCAT BAND
RELEASE AND WAIVER OF LIABILITY,
ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT

Please fill out this form in its entirety. If you have any questions, please contact us.

I,(Participant), hereby acknowledge that I have voluntarily elected to participate in the MCKENDREE UNIVERSITY MARCHING BEARCAT BAND to be held in and around the campus of McKendree University, from JULY 1, 2012 to JUNE 30, 2013. In consideration for being permitted by McKendree University to participate in the Event or Activity, I hereby acknowledge and agree to the following:

Voluntary Participation: I acknowledge that my participation is elective and voluntary and that my participation is not required by the college.

Rules and Requirements: I acknowledge that the college has the right to terminate my participation in the Event/Activity if it is determined that my conduct is deemed contrary to established rules and detrimental to the best interests of the group or college.

Release and Waiver of Liability: I, on behalf of myself, my personal representatives, heirs, executors, agents, and assigns, hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE the college, its governing board, directors, officers, employees, agents, volunteers, and any students (hereinafter referred to as “Releasees”) for any and all liability. I further agree that Releasees are not in any way responsible for any injury or damages of any kind that I may sustain as a result of my participation.

Personal Medical Considerations: I acknowledge that I am responsible for the cost of any and all medical and health services I may require as a result of participating in the Event/Activity. I further acknowledge and understand that Releasees may not have medical personnel at the location of the Event/Activity. In the event of any medical emergency,
I dodo not(initial one) authorize medical care that college personnel deem necessary.

I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS. BY MY SIGNATURE I REPRESENT THAT I AM AT LEAST EIGHTEEN YEARS OF AGE OR, IF NOT, THAT I HAVE SECURED BELOW THE SIGNATURE OF MY PARENT OR GUARDIAN AS WELL AS MY OWN.

Initials of Participant:

Date:

MM/DD/YYYY

Student McK ID:

I certify that I have custody of Participant or am the legal guardian of Participant by court order and that I have read this agreement and fully understand and agree to its terms.

Initials of Parent or Guardian: *

Email Address of Parent:

Date:

MM/DD/YYYY

Cell Phone:

### - ### - ####

By initialing, dating, and submitting this form, you are electronically signing it.