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Indemnification Form
INDEMNIFICATION, HOLD HARMLESS AND RELEASE OF LIABILITY AGREEMENT
Whereas, I desire ____________________________, who is my child/ward (hereinafter “Child”) to utilize Milford City (hereinafter “City”) property, facilities or equipment, and to engage in the ________________________ sponsored by City, and in consideration of City’s willingness to allow Child to use said property, facilities and equipment and to participate in said program, I ___________________________, as the parent/legal guardian of said child, herewith agree and promise to Indemnify and hold City, its officers, agents, officials and employees, and volunteers harmless and release them for and from any liability, costs or expenses arising from any action, causes of action, claims for relief, demands, damages, expenses, costs, fees or compensation, whether or not said action, causes of action, claims for relief, demands, damages, costs, fees, expenses and/or compensation are known or unknown, are in law or equity, and without limitation, all claims or relief which can be set forth through a complaint or otherwise that may arise out of my child use of city property, facilities or equipment, participation in the above described program or the acts or omissions, negligent or otherwise of Child, City and/or their respective officers, agents, officials, members, employees, and volunteers, or any person or persons.
I acknowledge that I have been advised to consult legal counsel and have had the opportunity to consult with legal counsel prior to entering into this Indemnification, Hold Harmless, Release of Liability Agreement.
I understand and agree that, by signing this Indemnification, Hold Harmless, Release of Liability Agreement, that I relinquish all rights or claims to adjudication or recourse to which I may be entitled in relation to any damages or injury that may arise out of the above described activities.
I warrant that I enter into this agreement with full knowledge of the meaning and future effect of the promises, releases and waivers contained herein.
I warrant that I have entered into the releases and waivers contained in this Agreement voluntarily and that I make them without any duress or undue influence of any nature by any person or entity.
I agree to assume all risk, chance or hazard that any loss sustained by me, my Child, or any other person or entity may be greater or more extensive than is known, anticipated or expected.
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Signature of Parent/Legal Guardian Date
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Printed Name of Parent/Legal Guardian Printed Name of Child/Ward
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Home Telephone Number
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