8/14/15│LAMARUNIVERSITYRELEASE&INDEMNITYAGREEMENTFORMINORSPage1
Activity Release and Indemnity Agreement for Minors
Participant Name (
Print):
Legal Guardian
(Print): ______________________________________________________
Organization:
Activity:
(Please describe specifically the activity)
Activity Dates:
This is a release of liability and assumption of risk agreement. Read it carefully and sign
below. Completion of this form is necessary in order to participate in this Activity. This
document cannot be altered or modified by any verbal or written statements.
_______ Releasees: The Board of Regents, The Texas State University System, Lamar University, and
all regents, employees, agents, and officers for these entities.
______ Release: In consideration for facilitating my child’s participation in the
Activity described above (hereafter Activity), I release, discharge,
and agree not to sue Releasees for any claims, demands, actions,
and causes of action of any nature whatsoever including a claim
of negligence, arising out of any loss or damage to my or my
child’s property and any injury, including death, that my child
may sustain whether or not caused by the negligence of the
Releasees, while participating in the Activity, supervised or
unsupervised, or while in transportation to and from the Activity.
_______ Risks: To the best of my knowledge, my child is in good health and has no physical
limitations that would preclude or impede my child’s participation in this Activity. I am
aware of the risks and hazards connected with the Activity, and I elect to allow my
child to participate voluntarily and engage in this Activity knowing that the Activity
may be hazardous to my property, my child’s property and my child. I voluntarily and
expressly agree and promise that I assume full responsibility for property loss or
damage, and for personal injury, including death that I or my child may sustain as a
result of being engaged in this Activity, whether or not based on the negligence or
other wrongful conduct of Releasees.
______ Indemnity: I also agree to indemnify and hold harmless the Releasees from
any and all loss, liability, damage, or costs of any nature
whatsoever, including court costs and attorney’s fees, that they
may incur due to my child’s participation in this Activity whether
caused by the negligence of Releasees or otherwise. For
example, I specifically agree to indemnify and hold harmless the
Releasees from losses they may incur as a result of my child
injuring another person or damaging another person’s property
while participating in the Activity.
Initial
Initial
Initial
Initial