Participation Release Form
Participant/Student:
Parent/Guardian:
Street Address:
Emergency Telephone No:
City/State/ZIP:
School-Event/Activity-Date:
10/10/2007
This Participation Release Form governs the above Participant/Student's involvement in the indicated school-sponsored or nonschool-sponsored event/activity made available to students and/or family of Lynden Christian Schools (hereinafter “LCS”), 417
Lyncs Drive, Lynden, Washington 98264, as follows:
Limited license for any event/activity on LCS property, using LCS equipment, or sponsored by LCS.
1. Entry/Occupancy: Participant/Student may enter and use the LCS property and equipment directly related to the above
event/activity only for the purposes and to the extent listed above for the dates and times listed above. Participant/Student is
not entitled to invite other participants.
2. Rules: Participant/Student agrees to abide by all posted or announced rules for the event/activity or premises (including, but
not by way of limitation, rules relating to speech, conduct, attire, alcohol use, tobacco use, and cleanup).
3. Summary Removal: Any person determined by an event/activity chaperone, or volunteer or staff of LCS, to be in violation
of the posted or announced rules may be summarily removed from LCS premises and/or discharged from the identified
event/activity.
Inspection of premises and equipment. Participant/Student acknowledges that he or she has or will have inspected the LCS
premises and equipment prior to entry or use, and the authorized use will be conducted only if he or she finds the condition and
design of the same safe, suitable and appropriate for the authorized use.
Condition of premises; Disclaimer of warranties. LCS disclaims any and all warranties, express or implied, regarding the
condition of its premises, the improvements or fixtures on the premises, or the equipment related to the identified event/activity. .
Waiver of claims. Participant/Student and Parent/Guardian, and his or her marital community, collectively waive all claims
against LCS and its staff, as well as any volunteers or chaperones for the event/activity, whether direct or obtained by assignment
or subordination, whether to itself, or to Participant/Student, and/or whether for property damage, personal injury, or other loss
arising from or in connection with its use or occupancy of LCS premises or equipment or participation in the identified
event/activity..
Indemnity; Hold harmless. Participant/Student and Parent/Guardian, and his or her marital community, collectively agree to
enter, defend, save and hold LCS and its staff, as well as any volunteers or chaperones for the event/activity, harmless from and
against any claim, suit or proceeding brought by any other person present during the event/activity, seeking compensation for any
nature of injury or loss arising during the event/activity. Participant/Student agrees to repair any damage to LCS’ premises, and to
repair or replace any improvement, fixture or equipment damaged during or on account of his or her participation in the
event/activity.
Limitation of remedies. In the event of the prosecution of any claim notwithstanding the above disclaimers and waivers, the
remedies of the Participant/Student and any member or invitee of the Participant/Student shall be limited to the actual, completed
damages or injuries incurred at the time of the event/activity, and there shall be no recovery for general or future losses, damages
or expenses.
Specific Program Description.
Signed by Participant/Student:
Signed by Parent/Guardian
(if Participant/Student is under age 18):
Date Signed:
Date Signed: