RELEASE OF LIABILITY

ACTIVITIES

PICKENS ACADEMY

I, the undersigned, desire to voluntarily participate in the following activity ___________________________________ (hereinafter “activity”). I represent that I am knowledgeable of this activity and the risks of personal injury or property damage to myself and to others which may be associated with the activity. Notwithstanding these risks, I wish to assume them by voluntarily participating in this activity and in any travel associated with this activity during the year.
I understand and agree that Pickens Academy accepts no responsibility for my acts or the acts of others while I am participating in and traveling in connection with this activity.
In consideration of Pickens Academy offering this opportunity and allowing me to participate in this activity, the receipt and sufficiency of said consideration being hereby acknowledged, I hereby do release, relieve, discharge and hold harmless Pickens Academy, its officers, trustees, employees, and representatives from any and all liability, whether for personal injury, property damage, or otherwise, arising out of or in connection with participation in this activity and any travel associated with this activity.

By signing below, I acknowledge that I have read and understand the Release of Liability.

IF THE PARTICIPANT IS NOT 18 YEARS OF AGE OR OLDER, THIS RELEASE MUST ALSO BE SIGNED BY THE STUDENT’S PARENT(S) OR LEGAL GUARDIAN.

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Date                                                                 Student

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Witness                                                            Print Name

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