11111 Santa Monica Blvd. Los Angeles, CA 90025
310-575-9400 x122
fostercarecounts.org
ASSUMPTION OF RISK AND HOLD HARMLESS AGREEMENT
INVITED GUEST/VOLUNTEER AT: The Willows School, 8509 Higuera St. Culver City,
CA 90232
THIS AGREEMENT WAIVES CERTAIN LEGAL RIGHTS.
CAREFULLY.
PLEASE READ IT
The Owners of The Willow School at 8509 Higuera St., Culver City, CA 90232 (the “Premises”), have
provided such property for use by Foster Care Counts (“FCC”), a charitable organization, for a social
function. FCC will not inspect for any defects in the property nor any dangerous conditions that could
cause injury, including, but not limited, to an unsupervised jungle gym. Undersigned guest hereby
releases FCC of any duties to do otherwise.
Therefore, in exchange for and as a condition of the use of the Premises, each guest must, and hereby
does, waive the right to any and all duties that FCC normally has and holds FCC harmless with respect
thereto. As a condition of entry, each guest/volunteer executes the following assumption of risk, waiver
of all claims, and hold harmless agreement, which terms are as follows:
Guest/volunteer hereby agrees to defend, indemnify, and hold Foster Care Counts and its officers and
directors harmless from and against any and all claims, losses, actions, damages, liabilities, and expenses
(including attorney’s fees) that:
(i)
(ii)
(iii)
arise from or are in connection with Guest/Volunteer’s possession, use, occupancy,
enjoyment, or attendance of the Premises, or any portion of the Premises;
arise from or are in connection with any willful or negligent act or grossly negligent act
of Foster Care Counts’ agents, employees, guests, licensees, invitees, directors or officers
or any other person authorized by the Owners and Occupants to be on the premises.
arise from injury or death to persons or damage to property sustained on or about the
Premises.
Presentation of this agreement may be used to dismiss any complaint via a demurrer or motion to dismiss
filed by Guest/Volunteer in any court in California.
Severability Clause: In the event any particular term or provision of this agreement is deemed by any
reviewing court to be unlawful or unenforceable, such particular term or provisions shall be severed from
this agreement, and the agreement shall otherwise remain in full force and effect.
Jurisdiction and Venue:
This agreement shall be interpreted pursuant to the laws of the State of
California, and the parties hereto submit to the jurisdiction of said state, and agree that the agreement is
entered into and to be performed in the County of Los Angeles.
I/WE HAVE READ AND AGREE TO THE TERMS AND CONDITIONS EXPRESSED IN THE
ASSUMPTION OF RISK AND HOLD HARMLESS AGREEMENT HEREIN.
Guest/Volunteer’s Name (print) ______________________________________
Guest/Volunteer’s Signature
Dated________________
______________________________________
If Guest/Volunteer is a Minor:
As the parent/guardian/legal caregiver of the minor, I accept the terms and conditions set forth
above.
Signature of Parent/Guardian/Legal Caregiver Ad Litem: _____________________
Dated _______________
Telephone No.: _______________________________