WAIVER AND RELEASE OF LIABILITY
AND ASSUMPTION OF RISK ACKNOWLEDGEMENT
1 understand that there are or may be risks and dangers inherent in my or my minor child’s participation in
the Asian Children Mentoring Program, hereafter the "Program". 1 also understand that in order for me or my minor
child to be allowed to participate in the Program, | must give up my rights to hold Asian Children Mentoring
Organization, its members, advisors, sponsors and affiliates , hereafter the “Organization”), liable for any injury or
damage which I or my minor child may suffer while participating in the Program,
Knowing this, and in consideration of my or my minor child being permitted to participate in the Program,
| hereby voluntarily release the Organization from any and all liability resulting from or arising out of my or my
minor child's participation. I understand and agree that lam releasing not only the entity set forth inthis paragraph
but also the officers, agents, representatives, advisors, and members of that entity
understand and agree that this Waiver/Release will have the effect of releasing, discharging, waiving and
forever relinquishing any and all actions or causes of action that I may have or have had, whether past, present or
future, whether known or unknown, and whether anticipated or unanticipated by me, arising out of my or my minor
child’s participation in the Program, except for the acts or omissions of the Organization, its officers, agents,
representatives, advisors. or members which are found to be grossly negligent by a court of competent juris
understand and agree that this Waiver/Release applies to personal injury, property damage, or wrongful
death which I or my minor child may suffer, even if caused by the acts or omissions of others. I understand and
agree that by signing this Waiver/Release, I am assuming full responsibility for any such risk,
[understand and agree that this Waiver/Release will be binding on me, my spouse, my heirs, my personal
representatives, my assignees, my children and any guardian ad litem for said children.
understand and agree that by signing this Waiver/Release, | am agreeing to release, indemnify and hold
the Organization, its officers, agents representatives, advisors or members harmless from any and al lability or
costs, including attorneys" fees, associated with or arising from my or my minor child’s participation in the Program.
understand and agree that if| am signing this Waiver/Release on behalf of my minor child, that I will be
aiving up the same rights for said minor as I would be giving up ifI signed this document of my own behall.
acknowledge that I have read this Waiver/Release Agreement and that I understand the words and
language in it. I have been advised of the potential dangers incidental to participating in the Program,
Dated: 2009 Print Name;_
Sign Name:
Parent/Guardian Release:
Tam the parent or legal guardian ofthe minor _
Waiver/Release on behalf of said minor.
and 1 am signing this
Signature of Parent: