Hold
Harmless
The
undersigned hereby agrees to assume all risks of injury to
my child and/or to myself, whether while on any part of the
premises of the Mothers’ Center for Fort Collins, Shepherd
of the Hills Lutheran Church or elsewhere while attending any
Mothers’ Center function and whether such injury occurs
by accident, by negligence or by any other cause whatsoever,
the undersigned hereby releases Mothers’ Center of Fort
Collins and Shepherd of the Hills Lutheran Church located at
1200 South Taft Hill Road, Fort Collins, their representatives,
teachers and attendants from liability for any injury whatsoever
to my child and/or myself and hereby waives any claims that
may arise due to hazardous conditions, so-called attractive
nuisances, negligence and all other similar matters that may
potentially cause injury to my child or to myself.
The
undersigned especially understands that the nursery services
being provided are principally for my convenience and are sponsored
by non-profit organizations which must require this assumption
of risk and release agreement in order to provide these services
for me and others like me.
This
release shall be continuing and shall apply to each and every
time the undersigned uses the above nursery and church facilities
or attends any Mothers’ Center of Fort
Collins function.
Names of all Children:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Print your
Name:
__________________________________________________
Signature:
__________________________________________________
Date:
__________________________________________________
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