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I I I I I I I I I I I I I I I I I I I I I I I I I I I I ~ \\st o.\-~ k YlA~ d...R_ -(j'---~ l"-0lo~~ k + l . ~II l..l....// f.7-'~- 1.~l~e.~ t=~._,- l~u~t~- s~~-Ii St-<Jt-rrwP-S · lo!- \Jv--- tr_rz4 l 1 %~-1AJ ~ 2- .f~~ TPt ~ ~ . 4u, 147 . 1.-14~ ( c§3 -·13fi.-. - \\)-o~ s~ ~ vu~t· ~ ~&~Oh .:::i J cn1/ -• - I 11:1-1~ ,_ ... -----. --.,,---..... ~ ;~·~l~~ - ~VJ~.-/ ..-I p!Abit.-~-~"1>..-~'~ '• ~ e~~ w J ~ · -----------11 ----tt----~l~5'. __ __..,...__,, ~- ,}-~~ < -----+;-----~~4 ~ .-,? ________ __. ----;.+--~ . Clvt~J ----------11 --~--i..;:;;..::;e~..;:;.~------'ff'l12?<-~11i...: Q ___ _ CJ ~ u-. ~v(c.. ~ BA1Uo~ ~~ ~u~@ ~s~~4 ~ ~;_~ _ ___,. . .;d~~~ V..(L@ {,f~~int.S~ . rf\.\£~· c/St.-ol ~ S f-IJASolf.~~-~-~-------t ~-a -----T-i/ o_y~ l~ )'fbll ~~ '\~it, u~ ~{ t\, Bo~@~ W•l--ti..~~-- ~~~~ ~~ /e ~o_{-_. --------1 ---~-LM,,~ --~~~Oh ~-' --- ~\ 0 J;:V\,_t_., ~ ~ V'~ Ml( ~~ ~ _____ 1°b l~t-~. ----~uA. tJ ~kcl-~+w-~ ltt~t-,-Ur>L ~ l~vi-l:L~~' ,..,.,_ V-".UH..t r-s ~ ~ t. .CrJ_1A-I~~. in~S · &"" O p\.LhltC: ~ohu..~ Y~ ~~ ~ t+ i e,J. J [J ~ A.6l-1.f e..i<Hl-S p 1ii¥~ -t ------1 f>~ (fY\ ~; cU-w &-. __________ ___, __ . f ~ olfuact<!>.~df· _,. ____ _ s'cr Pe.er~UN\. ---------------~ v~~~ --LJ ~ VtuV-p · f_f('(L-Tt~r ~ ~r~~f)O/) · --------1 ln-J_.,C,~ CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, 'Jilftr>i~ 6/r i() , am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments, officers, employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state : (Initial each line) ~am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and a ssume all risk and responsibility for any harm, injury, or damage, to myself or my p r operty, while I am on City owned property and while performing activities for my p a rticipation. ~ 1 shall fully defend, protect, indemnify, and hold harmless the City of College St ation, Texas, and/or its departments, agents, officers, servants, employees, successors, a ssigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its d epartments, agents, officers, servants, or employees, including, without limitation, p ersonal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. · 1 . . --. _, ... ' ' . ~agree to indemnify and hold harmless the City of College Station, Texas, and/or its ~t~ents, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. -::ffi;:1 further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors , volunteers , or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks, driving record checks, and/or drug screens when applicable to the duties , programs, or my participation in activities. ~ hereby give the City the right to photograph, televise, film, and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes, films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title, and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE _...;.01_.__ __ day of y'()~1 '20__£."'t Signature: ~~ Address: ____________ _ Printed Name: -:ir!mi.'1 Grt-e /) Telephone: __ ~;:;...__l _--=-J___..;;~_7)-_f(f)(,a_~ In case of emergency, please notify the following: Name: __ J;;--<-~_,_,,m~m-'--+f-~6[;~p~e~I)_,__ ______ Relationship : _ _,,._W,""-----'~'---"'..__ __ Home Phone: _____ Business Phone: _____ Mobile Phone: {p/?-lf77-72f J Doctor's Name: b)f. /Y)~SJ 0 Y ol Office Phone: q 71-{? 10-'fzUJ Doctor's Address or Hospital: __ '-f_Lf-'----2-=---<}-~---'---(.-'-'~'-'--"""-J ___::_C:,_f?_e•_i ~-~_f!J __ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR CHILD PARTICIPANTS I, ~"1Jl?Wl t;{>rft (\ , am allowing my child to participate in City activities. I and on behalf of my child, voltarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers, employees , agents , successors , assigns , sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow my child to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my child 's participation, they will be allowed access to various City facilities and may be allowed to use certain equipment. This release and indemnification shall apply for any rights of me or my child . I, agree to allow my child, Pr es~ ~fl/I ' to participate in the in City activities on the City of College Station's property and other locations. I understand that by signing below, my child will be allowed to participate in the City activities. It is further understood and agreed that my child will participate solely as an individual and not as an employee, contractor or agent of the City, its agents or employees and that all other terms and conditions of this agreement apply to my child . As consideration for the City of College Station allowing my child to participate, I hereby state: (Ini tial each lin e ) _0 am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. M and my child with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I or my child ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I and my child hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I or my child am on City owned property or any other property and while performing activities for my child's participation. ~and my child shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my child's participation. 1 ~nd my child agree to indemnify and hold harmless the City of College Station, Texas, or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages my child may suffer as a result of claims, demands, costs, or judgments against the City or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, or damage. _k-r further authorize the City 's employee or agent supervising thls activity to secure medical care for my child in the event of injury. I and my child promise to assume liability for payment, and hold harmless the City, its officers , employees , sponsors, volunteers, or agents , of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks , or drug screens when applicable to the duties, programs , or my participation in activities . --1I.rl. hereby give the City the right to photograph, televise , film , and sound record my child 's acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs , teletapes , films and sound recording shall be the exclusive property of the City and I and my child hereby relinquis h all rights, title , and interest therein. I , the undersigned, have read this release and indemnification and understand all its terms . I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE __ 1-_( __ day of f'/)47 ,20..£.L Signature: ff -Address: S?o1-S'r-AnKcw& {Y)_, PrintedNam~a:.:,~ <Jrv:el) Telephone: 0J<f -"/77-TU} Child's Printed Name: ~{J~fl 6ffeyt In case of emergency, please notify the following: Name: -----<1$Lt,,...._~-~~~-----------Relationship: MO~ Home Phone: _____ Business Phone: _____ Mobile Phone: tR/'f-'fl)· 72., r I Doctor's Name: \)t.; ~ LJ2. ~ ftJy-1 Office Phone: q J2-fo70-Y'iYD Doctor's Address or Hospital: } !PO 2 t2.r-Jc f ~ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, :J4m ~ Gff-ft'I , am being allowed to participate in City acti vities. I voluntarily and knongly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers, employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each line) ~am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ±i with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. k I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fmes, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. 1 ' . ' .... ?i agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees , whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. ~further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers , employees , sponsors , volunteers , or agents, of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks , driving record checks, and/or drug screens when applicable to the duties , programs, or my participation in activities. ~{r-r hereby give the City the right to photograph, televise , film , and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time , to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights , title , and interest therein. I, the undersigned , have read this release and indemnification and understand all its terms . I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE 7 f Signature:~ Printed Name: ~ ~ [,..af L1 day of In case of emergency, please notify the following: Address: rr,~1 '20..£6 szo+ ~-1&;--.wfyj~ Telephone:_(/;~) lJ~-LJ7 __ 7_ ... __.J_?-=---JJ __ Name: __ :se: ____ (~f~m_1_·oj,~~6/}-~~-f-~-----Relationship: -~l?~u~.>~kaJr;/=------,__- Home Phone: _____ Business Phone: _____ Mobile Phone: CZO) .. J~O-J-Z l(o Doctor's Name: -~/}J_____..._• ---+-{l;~"_GJ?_~~J_f<b/l ___ Office Phone: J 21 · 'Z() 2-3.QI'b Doctor's Address or Hospital: __ [_Z_~_(p~™~"f_1 _,~-;--<-'~-~g/~-"-------- 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR CHILD PARTICIPANTS I, ---MN]~ WI P ll , am allowing my child to participate in City activities . I and on behalf of my child , voltarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers , employees, agents , successors, assigns , sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereb y reques t that the City of College Station permit and allo w my child to participate in activities for the City, including but not limited to riding in City owned vehicles . As part of my child 's participation, they will be allowed access to various City facilities and may be allowed to use certain equipment. This release and indemnification shall apply for any rights of me or my child . I, agree to allow my child, N'~ Ovl'-!1 to participate in the in City activities on the City of College Station's property and other locations . I understand that by signing below, my child will be allowed to participate in the City activities . It is further understood and agreed that my child will participate solely as an individual and not as an employee, contractor or agent of the City, its agents or employees and that all other terms and conditions of this agreement apply to my child . As consideration for the City of College Station allowing my child to participate, I hereby state : (Initial each lin e ) ~ not an employee of the Cit y of Coll ege Station and all the activities I perform will be as a participant. As I am no t an employee, I am a parti cipant and will participate without pay and with no expectation of pay or any other benefits from the City. ~and my child with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I or my child ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I and my child hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I or my child am on City owned property or any other property and while performing activities for my child's participation. ~and my child shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, or its departments, agents, officers, servants, employees, successors, assigns , sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my child's participation. 1 -. '• \ "<"'l , . '}J ·~-·- ~and my child agree to indemnify and hold harmless the City of College Station, Texas, or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages my child may suffer as a result of claims, demands, costs, or judgments against the City or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, or damage. ±i further authorize the City 's employee or agent supervising this activity to secure medical care for my child in the event of injury . I and my child promise to assume liability for payment, and hold harmless the City, its officers , employees , sponsors , volunteers , or agents , of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks , driving record checks, or drug screens when applicable to the duties , programs, or my pa~ation in activities . ~ereby gi ve the City the right to photograph, televise , film , and sound record my child 's acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs , teletapes , films and sound recording shall be the exclusive property of the City and I and my child hereby relinquish all rights , title, and interest therein. I, the undersigned , have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE _ ...... G ..... l __ day of _V'IJ_'l_,.1-----' 20 1__~ Signature :~ Address : ~UR ST. AnkwJ;, DJ. Printed Name: "fWn1r!\f 6rf!£VI Telephone: fR /<j--.C) 77~ 7? £} Child's Printed Name: /))al,.J1 (. 6-fffr) In case of emergency, please notify the following: Name: --~-=--'-e-_ri_e_JIY\_l~_~(w __ .L--e_e_,1)-'"-----Relationship: ~ Home Phone: _____ Business Phone: _____ Mobile Phone: KDJ ... Jf fJ-/ ~ Doctor's Name: ____,V}l,.....,.,_.~6 ...... ~~------Office Phone: 1' 7 9-6 Jl6 .. YYS{) Doctor's Address or Hospital: -~/_f;_O~l_J2~b_ck~~ft_r;_WMJ._~*--------- CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR CHILD PARTICIPANTS ,, I, -S'4fr!Jnl4 , am allowing my child to participate in City activities . I and on behalf of my child, voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , -·its departments, officers, employees , agents , successors , assigns , sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow my child to participate in activities for the City, including but not limited to riding in City owned vehicles . As part of my child 's participation, they will be allowed access to various City facilities and may be allowed to use certain equipment. This release and indemnification shall apply for any rights of me or my child. .I I, agree to allow my child, 1,, Jc))~ , to participate in the in City activities on the City of College Station 's property and other locations. I understand that by signing below, my child will be allowed to participate in the City activities. It is further understood and agreed that my child will participate solely as an individual and not as an employee, contractor or agent of the City, its agents or employees and that all other terms and conditions of this agreement apply to my child. As consideration for the City of College Station allowing my child to participate, I hereby state: (Initial each lin e ) ~ am not an employee of the City of College Station and all the activities I perform will be as a p'6l:icipant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. a I and my child with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I or my child ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I and my child hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I or my child am on City owned property or any other property and while performing activities for my child's participation. /)A and my child shall fully defend, protect, indemnify, and hold harmless the City of College ".Btatio.;, Texas, or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my child's participation. 1 f ' ' ~ , _· : •. :·. i n ~· :> •. - ;;': ·\ t27Aand my child agree to indemnify and hold harmless the City of College Station, Texas, or its ~ments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages my child may suffer as a result of claims, demands, costs, or judgments against the City or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, or damage. ,02-rfurther authorize the City's employee or agent supervising this activity to secure medical care for ~ld in the event of injury. I and my child promise to assume liability for payment, and hold harmless the City, its officers , employees, sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks , or drug screens when applicable to the duties , programs , or my participation in activities. ~I hereby give the City the right to photograph, televi se , film, and sound record my child's acts , ~arances and utter es of me and to use any descriptive words or names, including my name in conjunction therewi and without limit as to the time, to produce and reproduce the same or any part thereof by any m od and to use for any purpose which the City deems proper. All such photographs , teletapes, fil and sound recording shall be the exclusive property of the City and I and my child hereby relinqui all rights, title, and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it vo luntarily and with full knowledge of its significance. day of ffJry Address: ,202V ~ 7-o=I-~-\. &ku,.;s {)) . SIGNED THIS THE °?/( Signature:~ - Printed Name: ~frl>l4.. Telephone:. __ ~-=-0___.__) -_3 __,,[Di:;_,,:___.,_._(-i.=.....>o<.D -lfc,;Jo Child's Printed Name: f us f i YJ In case of emergency, please notify the following: Name: -14-f---"--m_rn_t+-------"""'M~eJ/J------'----- Home Phone: Business Phone: _____ Mobile Phone: 0) 7 -977-7 t f / Relationship: ___ /'()_~~'-=--''""U--a. __ Doctor's Name: \)( . ki ft f{.Hl~S&--z? Office Phone: q 71-~'fb-lfv-10 Doctor's Address or Hospital: _ ....... /-=(p'--"""Q"----""'l . .___.f2«Jz..=...., ......... ,_, .._f '4L...="1'-'-"-'(''-"·e ............ /4d...::::30<..-'-------- 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR CHILD PARTICIPANTS I, :laf'lltv-. ~ 6f e f >\ , am allowing my child to participate in City activities . I and on behalf of my child, v-Oltarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments, officers , employees, agents, successors, assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow my child to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my child 's participation, they will be allowed access to various City facilities and may be allowed to use certain equipment. This release and indemnification shall apply for any rights of me or my child. I, agree to allow my child, ~'~ <ifet'1 , to participate in the in City activities on the City of College Station 's property and other locations. I understand that by signing below, my child will be allowed to participate in the City activities. It is further understood and agreed that my child will participate solely as an individual and not as an employee, contractor or agent of the City, its agents or employees and that all other terms and conditions of this agreement apply to my child. As consideration for the City of College Station allowing my child to participate, I hereby state: (Initial each line) A .., am not an employee of the City of College Station and all the activities I perform will be as a ~ant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ and my child with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I or my child ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I and my child hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I or my child am on City owned property or any other property and while performing activities for my child's participation. ;:{j:r and my child shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my child's participation. 1 ... ~" I and my child agree to indemnify and hold harmless the City of College Station, Texas, or its ~ments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages my child may suffer as a result of claims, demands, costs, or judgments against the City or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, or damage. ~I further authorize the City 's employee or agent supervising this activity to secure medical care for my child in the event of injury . I and my child promise to assume liability for payment, and hold harmless the City , its officers , employees , sponsors , volunteers, or agents , of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks , driving record checks , or drug screens when applicable to the duties , programs , or my participation in activities. f lf--r hereby gi ve the City the right to photograph, televise , film, and sound record my child's acts , ~~ces and utterances of me · and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs , teletapes, films and sound recording shall be the exclusive property of the City and I and my child hereb y relinquish all rights, title , and interest therein . I, the undersigned, ha ve read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE '[,,{ day of __ IYJ_~_7_,__ _____ , 20 cl Signature:~ Address: ____________ _ dW)M /_ PrintedName:~f~/) Telephone: wl9'-CJ7/-/c~j Child's Printed Name: In case of emergency, please notify the following: Name: __ _:-sif'=:....__'"'---"'-l _M:..i...J,__-oJ? __ ...... Gc""--'-e"'-''-!:........:/J'---'----Relationship: --~---- Home Phone: _____ Business Phone: _____ Mobile Phone: &, J 9-9 7 / .. ) 2{ J Doctor's Name: ---+{)1-u-_.__· _.H_n___::____:_..fu'-""'"'"'-L.4~ ......... ~::....__--Office Phone: ~7J .. tir6-Y'flo Doctor's Address or Hospital: -~J V-.--~o __ z_ __ &vk __ ~-e~~---~--------- 2 CITY OF COLLEGE ST A TION R ELEASE A ND I NDEMN IFICATION FOR P ART I C IPANTS I, ~ L~ ttd L (J.AJl'\~A , am bein g allowed to parti c ipat e in C it y act iv iti es. I vo lu nt a rily and K.nowi ng ly execute this release and ind emnificati o n w ith th e ex pr ess int e nt io n of effec tin g th e ex tin gui shm ent of any and a ll claims again st th e Cit y of Co ll ege Stati o n, Texas. it s de partments , officers , e mpl o ye es , agent s , s ucc es sors , a ss igns, sp o nso rs a nd vo lunt eers ass istin g in Cit y act ivitie s, whic h may res ult fro m th e ag reem ent as herein des ig nated a bove. Be in g ove r the age of 18 years and being of sound mind , I hereb y req uest that th e C it y o f Co ll ege Stati o n permit and a ll ow me to participate in act iviti es for the City, in c lu din g but not limit ed to ridin g in C it y owned vehicles. As part of my participation , I wi ll be a ll owe d acc ess to va ri o us C it y fa c ilit ies and may be a ll owe d to use certain equip ment or ve hicl es. As co ns iderati o n for th e Cit) 11' (',)lieg e Stati on a ll o w in g me to pa rticip ate, I hereby state: (Initial each lin e) {I I ,f I am not an empl oyee of the City of Co llege Station and all th e activ iti es I pe rfo rm w ill be ~artic ip ant. As I am not a n emp loyee , I a m a participant a nd w ill parti c ipat e w ith o ut pay and w ith no ex pectation o f pa y o r any o th er benefits fr o m the C ity. ~ with the intention of binding myse lf, my heirs, executors, admi ni str ators, and assigns, do hereby expressly release and di sc harge, all claims, demands , actions, judgments, and exe cution s, which I eve r had, or now have or may hav e, or w hich my heirs, executors, administrators, or assigns may ha ve, or claim to have, against the C ity of Co ll ege Station , and/or its depa r tments, its age nts, o ffic e r s, se r v ants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unkn ow n, and injuries to property, real or personal , caused by or arising out of, that sequence of events which occur from the agreement as here in designated above, or w hi ch may ar ise directly or indirectly from the performance of or created by or aris in g o ut of my participation during tim es of this indemnity agreement. I h ereby p ersonally accept and assume all risk and respon s ibili ty for any harm, injury, or damage, to my s elf or my property, while I am on City owned property and while performing activities for my participation. ~ I shall full y defend , p ro tect, indemnify, and hold harmless the City of College Station , Texas, and/or its departments, agents, officers, servants, employees, s uccessors, assigns, sponsors, or volunteers from and against each and every claim , demand , or cause of action and any and all liability, damages, obligations, judgments, losses, fin es, penalties, costs , fees, and expenses incurred in defen se of the City of College Station, Texas , and/or it s depa rtments, agents, officers, servants, or employees, including, without limitation , p ersonal inju ries and death in co nnectio n therewith which may be made or asserted by myse lf, my agents, m y success ors , my a ss igns, or any third parties on acco un t of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. ~L(,, I and my child agree to indemnify and hold harmless the City of College Station, Texas, or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from · any liabilities or damages my child may suffer as a result of claims, demands, costs, or judgments against the City or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, or damage. g/L1 further a uthori ze the City 's emp loyee or age nt sup ervisi ng thi s activity to sec ur e medica l care for my child in the eve nt of injury . I and my child promi se to assume liability for pa y ment , and ho ld harml ess the City , its officers , empl oyees, s pon so rs, vo lunteers, or agents , of medical expenses ar isin g from said medica l ca re for sa id injury a nd , I further authori ze th e City to pe rform cr imin a l hi stor y background checks , drivin g record checks , o r dru g sc ree ns whe n app li ca bl e to the duti es, pro grams , or my participation in act iv itie s. /l\)u1 here by g ive th e City the ri ght to photo g raph , te levise , film , a nd sound record my child 's ac ts, appearances and utterances of me and to use any descriptiv e wo rd s or name s, includin g my name in conjunctio n therewith and w ithout limit as to the time , to produce and reproduce the sa me or a ny part thereof by any method and to use for any purp ose w hich the City deems proper. All s uch photograph s, t e letapes, film s and so und recording sha ll be th e excl us ive prop e rt y of the Ci ty and I a nd my chi ld hereb y relinqui sh all ri ghts , title , and intere st therein . I, th e under s igned , have read thi s release a nd ind emni fication and und erstand all its terms. execute it voluntarily and with full knowl edge of its s ignificanc e. SIGNED THIS THE 2J_ day of fhJ , 20 ,iU. Signatu r./?.."41&.~lt-Address (.OO, ~ &Af P. Cf GU.,,,~hQr.. 'Tt fJf~S Printed Name :._/?.-=t(_...,,£.....,a~'b /,__· _..l"'--'-Gwi~"'-'0a,=-----Telephon ~=f7-J:P OJ -(f) lf ff== Child's Printed Name : Jo OJ'\ £ C~IA In case of emergency, please notify the following: Name: ~ ~/ ~-Relationship : //1C(fiu= Home Phone: Business Phone: Mobile Phone [ q T <?) f 31-cf3 l{ d-.__ --------------J Doctor's Name: Office Phone: --------------------------- Doctor 's Address or Hospital : ______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND I NDEMNIFICATION FOR CHILD PARTICIPANTS I, "lf4' ~1chv( L ~ , a m a ll owing my chi ld to pa rticipate in C it y act iviti es. I a nd on beh a lf of my c hild , vo lunt ar il y a nd knowin g ly execute thi s rel ease and ind e mnifi cation w ith the expres s in tention of effecting the extingu ishm ent of any and a ll c la im s aga in st th e City of College Station , Texa s. its depart ment s, officers , employees , agents , s uccessors , ass igns , s pon sors and vo lun teers ass ist in g in Cit y act iv iti es , which ma y resu lt from th e agree ment as herein designated above. Bein g ove r the age of 18 yea rs and be in g of so und mind , I hereby reque st that th e City of Colle ge Stat ion permit and al low my child to particip ate in act ivit ies for the C it y, in c ludin g but not limited to riding in City ow ned vehicle s . As part of my child's participation , the y w ill be a ll owe d access to various Cit y fac iliti es and may be a ll owed to use ce rtain equipm e nt. Thi s relea se a nd in demnifi cat io n sha ll apply fo r any rights of me or my c hil d. I, agree to a ll ow my c hild , G1 1du..!Yn C'unk , to particip ate in the in City activities o n the C it y of Co ll ege Statio n's pr o pert y and ot her locations. I und ersta nd th at by s ignin g be low , my chi ld will be a ll owe d to part ic ip ate in the C it y activ it ies . It is further unde rstood a nd agreed that my ch ild will pa rti c ip ate so lely as an indi v idual and not as an e mplo yee, contrac tor or agent of the Cit y, its agent s or employees a nd that a ll oth er terms and co ndition s of thi s agreeme nt appl y to my c hild . As considerati on for the City of Co ll ege Statio n allow in g my c hild to partici pate , I hereby state: (Initial each line) ~ I a m not an emplo yee of th e C it y of Co ll ege Station a nd all th e ac tivitie s I perform will be as a particip a nt. As I am not an e mplo yee , I a m a participant and will partic ipate without pay and w ith no expectatio n of pay or a ny oth er benefit s from the City. f. l,\; I and my child with the intention of binding myself, m y heirs , exe cutors, admi ni strators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, w h ich I or m y child ever had, or now have or may have, or which m y heirs, executors, administrators, or assign s ma y ha ve, or claim to have, against the City of Co ll ege Station, or its departments, its agents, officers, se rvants, successors, assigns, sponsors , volunteers, or emp loyees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this ind emnity agreement. I and my child hereby personally accept and assume all risk and responsibility for any harm , injury, or damage, to m yse lf or m y property, while I or my child am on City owned property or any other property and while performing activities for m y child's participation. {) lL_ I and m y child shall full y defend , protect, indemnify, and hold harmless the City of College I'' Station, Texa s, or its departments, agents, officers, servants, employees, s uccessors, assigns , sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, a nd expenses incurred in d e fense of the City of College Station, Texas, or its departments, agents, officers , servants, or employees, including, without limitation, pers onal injuries and death in connection therewith which may be made or asserted by m yself, my agents, my s uccess ors, m y assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the perform a nce of this agreement and from my child's participation. ~ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs , or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, se rvants, or e mployees, whether that negligence is the sole or contributing cause of the resultant inju ry, death, and/or damage. ~ I further aut ho ri ze the C it y 's employee or age nt supervis in g this activity to se c ure med ical care for me in the event of injury . I promise to assume liability for pa yment , and ho ld harmle ss the City , its officers , e mpl oyees , sponsors , vol unt eers , o r agents , of medic a l ex pe nses ari s in g from sa id medical care for sa id injury and , I further authorize the City to perform criminal hi story background check s, drivin g record checks , and /or drug screens when app li cable to th e dutie s, programs , or my participati on in activities. o \ V I her eby give the C it y the right to photograph , televise , film , and sound record my acts , ~ances and utterances of me and to use any descriptive words o r names , includin g my name in conjunction there w ith and w ith out limit as to the time , to produc e and rep rod uce the sa me or any part there of b any meth od and to use for any purpose which the City deems proper. All such photographs , teletapes , film s a nd so und recordin g s hall be the exc lu sive property of th e City and I hereby relinquish all rights , title , and int eres t therein . I, the undersigned , ha ve read this release and indemnification and understand a ll it s term s. I execute it volu nt arily a nd with full kn ow ledge of its s ignifi cance . SIGNED THIS THE 2 I day of (Yl ~ , 20,;Q. Signaturc•f}"4l~-,-...... -----..,---Addres: 6t() S.,, "6,~;W cf ~fM);f('~Uj Printed Name: 'Ke.: Ch l> ... d L CVJ/I h11 Telephone: ( 171 'r!J1 -J3 l(J, 7 In case of emergency, please notify the following: Name : Bvl ~k Relationship : J/u f:bw J Home Phone: ______ Business Phone: ______ Mobile Phone{ 2o~) 351"%1 q 5 Doctor 's Name: Office Phone: ------------------------- Doctor 's Address or Hospital :------------------------- 2 CITY OF COLLEGE ST A TION RELEASE AND IND EMNIFICATION FOR CHILD PARTICIPANTS I ,&_~ G.4A , am a ll owing my child to parti cipate in City activities. I and on behalf of'my child , vo lun taril y and knowingly execute thi s release and indemnification with the expre ss int ention of effecting the extin g ui s hment of any and a ll claims aga inst the City of College Station , Texa s, it s departments , officers, employees , agents , succe sso rs , assigns , s pon sors and vo lun teers ass isti ng in City activities, which may result from the agreement as herein designated above. Bein g over the age of 18 years and bein g of sou nd mind , I hereby reque st that th e City of Co ll ege Station permit and allow my child to participate in activities for the City , in c luding but not lim it ed to ridi ng in City owned vehicle s . As part of my chi ld 's particip ation , they w ill be allowed access to various City facilities and may be allowed to use certain e quipm e nt. This release and indemnification shall app ly for any rights of me or my c hild . I, agree to a llow my child , '"Yocui Gm~......_ , to part icip ate in the in Ci ty activitie s on th e City of Co lle ge Statio n's property a nd other loc:atio;;s. I ~dersta nd that by s ig nin g b..:l ow , my child w ill be allowed to participate in the City activities. It is further understood and agreed th at my child will participate so lely as an in di vid ual and not as an emp loye e. contrac tor or age nt of th e City, it s agent s or employees a nd that a ll ot her term s and cond ition s of th is agreement apply to my child. As co ns ideration for the City of College Stat ion al low in g my child to participate , I here by sta te : (Initial each line ) gl-l I am not an e mploy ee of the City of Co ll ege Station and a ll the act ivitie s I perform will be as a participant. As I am not an employee , I a m a participant and wi ll parti cipate withou t pa y and wi th no expectatio n of pay or a ny other benefits from the City. ~I and my child with the intention of binding m yse lf, m y heirs, executors, administrators, and assigns, do h ereby ex pressly release and discharge, all claims, d emands, actions, judgments, and executions, which I or my ch ild ever had , or now hav e or may have, or which my heirs, executors, administrators, or assigns may have, or claim to ha ve, against the City of College Station, or its departments, its age nts, officers, serva nts, s ucce ss ors, assigns, sponsors, volunteers, or employees, created by, or arisi ng out of perso nal injuries, known or unknown , and injuries to property, real or personal, caused by or arising out of, that se quence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of m y participation during times of this indemnity agreement. I and m y child hereby personally acce pt and assu m e all risk and responsibility for any harm, injury, or damage, to myself or m y property, while I or my child am on City owned prope rty or any other property and while p e rformin g activities for m y child's partici pation . ( (,..{/ I and my child shall fully defend, protect, indemni fy, and hold harmles s the Cit y of College Station, Texas, or its departments, agents, offi cer s, serva nt s, employees, successors, assigns , sponsors, or volunteers from and against each and every claim, demand , or cause of action and an y and all liability, damage s, obli ga tion s, judgment s, losse s, fines, pen alti es, costs , fees, and expen ses incurred in defense of the City of College Sta tion , Te xas, or it s departments, agents, officer s, servants, or emplo yees, including, without limitation , p e r so nal injuries and death in connection therewith which may be made or asserted by m yse lf, my agents, m y successors, m y assigns, or any third parties on account of, arising ou t of, or in any way incidental to or in connection with the performance of this agreement a nd from m y child's participation. ~ I and my child agree to indemnify and hold harmless the City of C ollege St a tion , Texas, o r it s departments, officers, agents , servants, emplo yees, successors, assigns , sponsors, o r volunteers fr om an y liabilities or damages my child ma y suffer as a result of claims, demands, co st s, or judgments against the City or, its departments, its officers, agents, servants, or employee s, created by, o r arising out of the agreement herein designated above and from my participation includin g, but not limited to, claim s and damages arising in whole or in part from the negligence of the City of Coll ege Station or the parties to this agreement. It is understood and agreed that the ind e mni ty prov ided for in this section is an indemnity extended b y the participant to indemnify and protect the City of College Station or its departments, agents , officers, servants, or employees from the con sequenc es of the negligence of the City or its departments, agents, officers, servants, or employee s, wh ethe r that negligence is the sole or contributing cause of the resultant injury, death, or d a mage. fZ.C..C I furth e r aut hori ze th e C it y's emplo yee or age nt s up ervis in g thi s act ivit y to secure me d ic a l care fo r my child in th e eve nt of injur y. I a nd my child promi se to ass um e li a bility fo r pay me nt, and ho ld harml ess th e C ity, it s offi ce rs, empl oyee s, s ponso rs, vo lun tee rs, or agen ts, of medi ca l ex pe nses a ri sin g fro m sa id medi ca l ca re for sa id injury a nd , I furth e r a uth ori ze th e C ity to pe rform cr imin al hi stor y backgroun d c hecks, drivin g reco rd check s, or dru g sc ree ns whe n a ppli ca bl e to th e du t ies, pro gra ms, or my parti ci pation in ac ti viti es . l__L_0 her e by g ive th e Cit y th e ri g ht to ph otogra ph , te lev ise, film , a nd sound rec ord my c hild 's act s, a pp earances an d uttera nces of me and to use a ny desc ripti ve wo rd s or na mes , in c lud in g my name in conj un ct ion th e rew ith and with o ut lim it as to th e ti me, to prod uce and re pro du ce the sa me or a ny part th ereof by an y met hod and to use fo r a ny purp ose which th e C it y dee ms prop e r. A ll s uc h photograp hs, te let a pes , film s and sound recordin g sha ll be th e exc lu siv e pro pe rt y of th e C it y a nd I a nd my c hild here by re lin q ui s h a ll ri ghts , ti t le, and int eres t th ere in . I, th e un der s igned, have rea d thi s re lea se and ind e mnification and und er stand al l it s ter ms. exec ute it volun tarily a nd with full kn ow ledge of its s ignifi ca nce. SIGNED THIS THE _...J......,/.._ __ day of f6 'J , 20 .Ld-. Signature•~c;i C,4 4,.'= Address fLt;_ S.,,, Buu1u cf (,°!' .'ta_hm //;79!'15 Printed Name : _hcltlk{ l, ~ Telephone: {172) 1--? '1 ? p J t/ :A.._ Child 's Printed Name: 61'4.uJh [,~-= In case of emergency , please notify the following: Name : :£4_,i[,,,~1 J {hll) hA Relationship : __,A_Yl_,_.v~#ur~~--- Hom e Phone: _____ Business Phone : _____ Mobile Phon t( q rq) j:3q -[1; tJ 7- Doctor's Name :----------------Office Phone :---------- Doctor 's Address or Hospital :-------------------------- 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, ~ l \\Coe:...~~' am being allowed to participate in City act1v1ties. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers, employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e ) ~I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. ~t I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants,. employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __ I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks, and/or drug screens when applicable to the duties, programs , or my participation in activities . __ I hereby give the City the right to photograph, televise , film, and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part the reof by any method and to use fo r any purpose which the City deems proper. All such photographs , teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title , and interest therein . I, the undersigned, have read this release and indemnification and understand all its terms . I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE ~\ day of (Y) c'=t , 20 ()_ Signature: ~ ) \((b~ Address: L:, DO G:,0'1\"" ~( Printed Name: (S L \ \ Cc_::c('f'L \j--Telephone: C\\C\. 4-J'"b 'L-5t-\] In case of emergency, please notify the following: Name: (_Ct'\~ b~-· \~~..----Relationship: \_..) >;e_ l_\51)~1...S'-\\ Home Phone: Business Phone: Mobile Phone: ~~~~~-~~~~- ~ Doctor's Name: ), ~Q-"' \ Doctor's Address or Hospital : ~ S d-t....J ~~~~~~~~~~~~~~~~~~~~~~~- Office Phone: ~ &:;)-~ ':> l ') 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, Q e 11'111 2 ~4f~ am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers, employees, agents , successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each line) ~ot an employee of the City of College Station and all the activities I perform will be as a participant., As I am not an employee , I am a participant and will participate without pay and with n J)ectation of pay or any other benefits from the City. I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. ----~ully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or amage. I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees , sponsors , volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history backgr d checks, driving record checks, and/or drug screens when applicable to the duties, pr ams , or my participation in activities . I hereby give the City the right to photograph, televise, film , and sound record my acts, appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title , and interest therein . I , the undersigned, have read this release and indemnification and understand all its terms . I execute it voluntarily and with full knowledge of its significance. _........_...+'----day of __ Jvf ............ _7:;.......y....---' 20L.2_ Address: ------------- In case of emergency, please notify the following: Home Phone: Business Phone: Mobile Phone: ----------------- Doctor's Address or Hospital : _______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS 1~1c..1::_.';;>JS!]OH'l.L) , am being allowed to participate in City activ1t1es. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments, officers, employees, agents, successors , assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate , I hereby state: (Initial each line) ~I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. "P5 I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. ~ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agen ts, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __EL_ I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks, driving record checks, and/or drug screens when applicable to the duties, programs, or my participation in activities. ~ I hereby give the City the right to photograph, televise, film, and sound record my acts, appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to u se for any purpose which the City deems proper. All such photographs, teletapes, films and sound recording shall be the exclusive property of the City and I hereby re linquish all rights, title, and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it vo luntaril y and with full knowledge of its significance. SIGNED THIS THE __ 7_......7 __ day of _MN.;........;;.....__ _______ , 20 -Z...':-.. Signature:~ Printed Name:?~)(..~ In case of emergency, please notify the following: Telephone: ~""Vi-~ 7b-lb-JS Relationship : _W~>-~------ Home Phone: ______ Business Phone: ______ Mobile Phone: t:;-,c;,5-, J· '&''~ Doctor's Name: Office Phone: -------------~ --------- Doctor's Address or Hospital : _______________________ _ s+ odclAfd' 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I , \.t,nn1lr/ G11P~ /k-, am being allowed to participate in City act1v1tles . I voluntarily~d knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments, officers , employees, agents , successors , assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles . As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate , I hereby state: (Initial each lin e ) am not an employee of the City of College Station and all the activities I perform will be a a participant. As I am not an employee, I am a participant and will participate without pay an~ ~ith7ectation of pay or any other benefits from the City. @ ~i~h the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. fully defend, protect, indemnify, and hold harmless the City of College tion, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages , obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. /\/.agree to indemnify and hold harmless the City of College Station, Texas, and/or its ~t:Oents, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or a r ising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or [---,'.ft--- I further authorize the City's employee or agent supervising this activity to secure medical c e for me in the event of injury. I promise to as sume liability for payment, and hold harmless the City, its officers , employees, sponsors, volunt eers , or agents , of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks , and/or drug screens when applicable to the duties , programs or my participation in activities. I hereby give the City the right to photograph, televise, film , and sound record my acts, earances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title , and interest therein . I, the undersigned, hav e read this release and indemnification and understand all its terms . I execute it v oluntarily and with full knowledge of its significance . SIGNED THIS THE-~-\ __ day of rn~ , 20 ~ Signat ~ Address: IDS'S~ rJrru._)~Dv-- Printed Telephone: q 2 C/ .5 7 5 L(3Jj In case of emergency, please notify the following : Name: ~ f.Q Gn Jt~ Relationship: ;rd/,. -Iv Home Phone: _____ Business Phone: _____ Mobile Phone: f}f tf f 2 /P.3 ~.2 Doctor's Address or Hospital : _______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, f'VJ ,\ k1.. kn '" f.7 ~\v , am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments , officers , employees , agents, successors , assigns , sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City , including but not limited to riding in City owned vehicles . As part of my participation , I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e ) 4 I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. < I shall fully defend, protect, indemnify, and hold harmless the City of College ~n, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my particip a tion including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __ I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury . I promise to assume liability for payment, and hold harmless the City, its officers, employee s , sponsors, vol unteers, or agents, of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks , driving record checks , and /or drug screens when applicable to the duties, programs , or my participation in activities . __ I hereby give the City the right to photograph , televise , film , and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and wi thout limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights , title , and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and wit~r-11 knowledge of its significance. SIGNED THIS THE ?_ \ day of VV\ &iq , 20 2-7- Signatu ~~ Printed Name: IN1 . k \L..,,.._ I\\? ( In case of emergency, please notify the following : Name: tJI <-o \.-L Address: L.-'t S: ~ Tv\ ~ \ r 0 L Telephone: i;-I 1... -Ya, I ""' S (, C\ '-I Relationship: (-p;.~,.. r) Home Phone: Business Phone: Mobile Phone: ~~~~~~ ~~~~~~ ~~~~~ Doctor's Name: Office Phone: ~~~~~~~~~~~~~~ ~~~~~~~~~ Doctor's Address or Hospital : ~~~~~~~~~~~~~~~~~~~~~~~~ 2 CITY OF COLLEGE ST A TION RELEASE AN_D INDEMNIFICATION FOR PARTICIPANTS I, fZ c. (a "l J 5o C.JGt +u{ am being allowed to participate in City act1v1ti es . I voluntari ly and knowingly execute this release and indemn ification with the express intention of effecting th e extinguishment of any and all claims against the City of College Station, Texas , its departments, officers , employees, agents, successors, assigns, sponso rs and volunteers assisting in C ity activities, which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind, I hereb y request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned ve hicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for th e City of College Station allowing me to participate, I here by state: (Initial each line) ~am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. cl. I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs , executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or m y property, while I am on City owned property and while performing activities for m y participation. (iJ:<--I sh all fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors , assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all.liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted b y myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold)larmless the City of College Station, Texas , and/or its departments, officers, agents, servants, employees, successors , assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to , claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers , servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers , servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death , and/or damage. __ I further authorize the City's emplo yee or agent s up ervising this activity to secure medical care for me in the event of injury. I promise to assume li abi lity for payment, and hold harmless the City, its officers, emp lo yees, sponsors, vo lunteers, or agents , of medical expenses arising from said medical care for said injury and , I further authorize the City to perform crimina l history b ackground checks , driving record checks, and/or drug screens w h en applicable to the duties , programs, or my participation in activities . __ I hereby give the City the right to photograph , te levis e, film , and sound record my acts, appearances and utterances of me an d to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the C ity deems proper. All such photograph s , teletapes , films and sound recording shall b e the ex clusive property of the City and I h ereb y relinquish all rights , ti tl e, and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it vo luntarily and w ith full knowledge of its signifi cance. SI~D ~ms ff' l-f day of M ~ , 20 2-~ Signatu #~Jq Address: Z--~0'2 {,~<&v-.rot--Cf 77J'VJ - Printed Nam e: (Z o lo.."""' J ~ck we., 1-z..e-r Telephone: q 1 4'-1 ~ '{ -I.{ of D In case of emergency, please notify the following: Name : __ (ri_/;..__s_b_V'\ __ 'S_c_~_vJ_e_,_'-~_2-...R/" _____ Relationship : __ 5_o_i.-i ___ _ Home Phone: Business Phone: Mobile Phone: '1 1 '1 -7 () )-O 7 ~ t.( ------------- Doctor's Name: _:=,_t _{Nl.._f-~-,-J~ ______ Office Phone : 9 7 f r;;, 'f 3 J 3; J Doctor's Address or Hospital: __ 1_5_(_2. __ ~J~fo~(_f e_W'(A~~n~----------- 2 CITY OF COLLEGE ST A TION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, S""-J'o.""" Woe cfard._ , am being allowed to participate in City act1v1hes. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments , officers , employees, agents, successors , assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being ov er the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation , I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state : (Initial each lin e ) ~vvl am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City . __ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. ~ shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. .J-FV' I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims , demands, costs, or judgments against the City and/or, its departments, its officers , agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to , claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended b y the participant to indemnify and protect the City of College Station and or its departments, agents, officers , servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officer s, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, d eath, and/or damage . .,,J-:AJ1 further a uthorize the City's employee or agent s up ervising this activity to sec ure medical care for me in the event of injury. I promise to assume liabili ty for payment, and hold harmless the C ity, its officers, empl oyees, sponsors, volunteers, or agents , of medical expenses arising from said medical care for said injury and , I further authorize the City to p erform criminal history b ackground checks, driving record checks, and/or drug screens when app li cable to the d uties, programs , or my participation in activities. ~ h ereby give th e City the right to photograph, televise , film , and sound record my acts , appearances and utterances of me and to use any d escriptive words or names , incl uding my name in conjunction therewith and without limit as to the time , to produce and reproduce the same or any part thereof by any method and to use for any purpose which the C ity deem s proper. All such photographs, teletapes, films and sound recording sh a ll b e the exclus ive property of the City and I hereby relinquish all rights , title, and interest therein. I, the under signed, have read this release and indemnification and understand all its terms. I execute it vo luntarily and with full knowledge of its significance. SIGNED THIS THE 2 /Jr day of MtL'J , 20 _2_~ S ignature :~-:t'y~ Address: 2~0"")_ Ct~v-r~ C.-r Printed Names;: I?\ ....... L. We v c(Q-y'"" j Telephone l q9-'t.. J ;2 \ 9 -\( )_ tf' In case of eme rgency, please notify the following: Name: Pvlc....,...l Q..~~ t ~ Relationship : S'f~.)--1L Home Phone: Business Phone: Mobile Phone: ('f=t-6f) 111-?. yqr/ Doctor's Name: t21. C. ~«!. JlN--(f.> 1 S+w J Office Phone : ~W-1-2Y-Mt Doctor 's Address or Hospital : l ~ rJ V' ,~vs \i=J V '·6) L~ ). 1K ·1 =t-t vb 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, V\CA r '1 SA Q\OV\.~ ' am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments , officers, employees , agents, successors, assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e ) ,M I am not an employee of the City of College Station and all the activities I perform will be ~articipant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. fl}) I with the intention of binding myself, my heirs, executors, administrators, and ~s, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. " fl:\ I shall fully defend, protect, indemnify, and hold harmless the City of College ~n, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. jfli) I agree to indemnify and hold harmless the City of College Station, Texas, and/or its ~tments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agen ts, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. -{;J I further authorize the City 's emp lo yee or agent sup ervising this activity to secure medical ~or me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees , sponsors , volunteers , or agents , of medical expenses aiising from said medical care for said injury and, I further authorize the City to perform criminal history background checks, driving record checks, and/or drug screens when applicable to the duties, programs, or my participation in activities . ~ I hereby give the City the right to photograph, televise , film, and sound record my acts, ~ances and utterances of me and to u se any descriptive words or names, including my name in conjunction therewith and witho ut limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City de ems proper. All such photographs , teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title, and interest therein . I, the undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. SIGN1(f 1T~ISTH!~ dayof M ~ ,20 .:1..1-- Signatur Address: 4 \ t 0 EV\ ll5 Ct, Printed Name: M,Clv\[I\. '6\uY\el1 Telephone: ~\1 21.Jt) 1 ~1 ( In case of emergency, please notify the following: Name: 1fJ-i oo \Al. Relationship : S"'(2.j./lfi0 Home Phone :~~ )qL, >it:iness Phone: __ -___ Mobile Phone:------- Doctor's Address or Hospital : _______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, rJ i (_ o }.(_ f<.ow \~\le, am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers , employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation , I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e) L I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. -V.--I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation . ..l__ I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas , and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __j_ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. _j_ I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees , sponsors , volunteers, or agents, of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks, driving record checks, and/or drug screens when applicable to the duties , programs , or my participation in activities. _J_ I hereb y give the City the right to photograph, televise, film , and sound record my acts, appearances and utterances of me and to use any d escriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby r elinquish all rights , title , and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms . I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE 2.( sf- Signature ./'/,~ ........ ~ Printed Name: N co>\L @cw\ .aJ.f-t day of ~Maj , 20 2."2.. In case of emergency, please notify the following: Name: Lerw\V\ Address: 0 . .J \) ~b Lb ~ De Telephone: '{ DS -lf±~9:J q loB Relationship: ~.--othe..r Home Phone: _____ Business Phone: _____ Mobile Phone: 0J1-Z 29 -~ f ')1 Doctor's Name: Office Phone: -------------~ --------- Doctor's Address or Hospital: _______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, A-,..,. .2 ,,,, (;'C.. "(, '. -h [..... , am being allowed to participate in City act1v1tles. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments , officers , employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles . As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial eac h lin e) £I am not an employee of the City of College Station and all the activities I perform will b e as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City . .1JJ I with the intention of binding myself, my heirs, executors, administrators, and ~s, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my I 'cipation. I shall fully defend, protect, indemnify, and hold harmless the City of College n, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. I agree to indemnify and hold harmless the City of College Station, Texas, and/or its artments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agen t s, officers, servants, or employees. from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. Aff) I furth er authorize the City's employee or agent supervising this activity to secure medical ~or me in the event of injury. I promise to assume liability for payment, and hold harmless the City, it s officers, employees, sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks, and/or drug screens when applicable to the duties , programs , or my participation in activities. _lp . I hereby give the City the right to photograph , televise , film, and sound record my acts, ~ances and utterance s of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereo f by any method and to use for any purpose which the City deems proper. All such photographs , teletapes, films and sound recording shall be the exclusive property of th e City and I hereb y relinquish all rights, title , and interest therein. I, th e undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. _____ day of ~·f , 20 ;..t_. Signature: Address: g,£c o /s i;re s f w 0 ",{ J>~ In case of emergency, please notify the following: Name : "?t" k<-/ )c s ) Relationship: 6.~ If/ L .-..J Home Phone: Business Phone: ______ Mobile Phone: fli 2.Z '/ "j 27 s- Doctor's Name: i>\)c..J.,_ '"1 """"'-!. 1 .. ,J ~ Office Phone: 1 7'1 7 3 / i'(; ~ (., Doctor's Address or Hospital : _______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, ~-((_ ~ ~ l I , am being allowed to participate in City actlv1t1es . I voluntarily and knowiwgly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments , officers, employees , agents , successors , assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state : (Initial each lin e ) __ I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. __ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions , which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold harmless the City of College Station, Tex as, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers , agents, servants, or employees , created by, or arising out of the agreement herein designated above and from my participation including, but not limited to , claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, ag ents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees , whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __ I further authorize the City 's emp lo yee or agent sup ervising this ac ti vity to secure medical care for me in the event of injury . I promise to ass um e liability for payment, and hol d harm less th e City, its officers, employees, sponsors , volunteers, or agents , of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks , and /or drug screens when applicable to the duties, programs , or my participation in act ivities. __ I hereby give th e City the right to photo grap h , televise, film , and sound record my acts, appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and witho ut limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes, films and sound recording sha ll b e the excl usive property of the City and I hereby relinquis h all rights , title , and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it vo luntarily and with full knowledge of its significance. SIGNEDTHISTHE ;/(-;s:t dayof __ ~--~'> ___ ,20 :}0_ Signature :~(~ Address: ~lb:> f'c\-co (?f C~~.f r Printed Name: --r:-u__ ~ l ( ( /f-V> Telephone: d <;;-{ ,_ '-() l ~ cJlo C \ In case of emergency, please notify the following: Name: __ flt_(_l_,_(--=-S'"-°'=--'----'~-...... C_..\ _____ Relationship : k-J~ ~ Home Phone: ______ Business Phone: ______ Mobile Phone: 2 ~I ,.-(([}f r ~~\ 2 CITY OF COLLEGE ST A TI ON RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, l~..:.k>-v + iq_v--d \V-..., am being allowed to participate in City act1v1ties. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments , officers , employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial eac h lin e) L i am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs , fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. ~I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to ind emnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. \1'Y!__ I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers , employees , sponsors, volunteers , or agents , of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks , driving record checks, and/or drug screens when applicable to the duties, programs , or my participation in activities. ~ I hereby give the City the right to photograph, televise , film , and sound record my acts, appearances and utterance s of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs , teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title , and interest therein. I, the undersigned , have read this release and indemnification and understand all its terms. I execute it volu tarily and with full knowledge of its significance. I.~ day of ~ ,20 2 :L \ Signature: Address: '< C\. \CD ( c.,v..: l l ...z Printed Name: ~~ Telephone: q (~ -)l y ~Ou~ In case of emergency, please notify the follow ing: Name: __ '_,_/_G.....,_~_· __ Qi_~_v--_l.A..-__ l '_c,.._ ______ Relationship : __ Lv_!-+-~----/ --j Home Phone ~ Business Phone: Mobile Phone:'l l q_ 1) 'f ~~~~~-~~~~~- Doctor's Name: 'Q.-....· (i ~·i,f U..cr d Office Phone: ~~~~~~~~~ Doctor's Address or Hospital: <;_Cl W ~~~~~~~~~~~~~~~~~~~~~~~- 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, fatrchJfe{?e.,,(Yf± f ;J-rk;l (.';;;/at1t~f to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments, officers, employees, agents , successors , assigns , sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e ) --1tf._ I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. _!::f!_ I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. -J42-I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to in d emnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. Ci\ /7 I further authorize the City's employee or agent supervising this activity to secure medical ~or me in the event of injury. I promise to ass ume liability for payment, and hold harmless the City, its officers, employe es, sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks, driving record checks, and/or drug screens when applicable to the duties , programs, or my participation in activities. ~ I hereby give the City the right to photograph, televise, film, and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and witho ut limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title , and interest therein. I, the undersigned , have read this release and indemnification and understand all its terms . I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE ~\ day of ti-7' , 20 'A; Signature~~ Address?aqJ{<_"'-y bv'/vt c+. Printed Name:fitlc±tl (.Q__ f e.j Crfi--Telephone: 3 0d .,..iLf lf) S Cf In case of emergency, please notify the follow ing: Name: //-),~Lv? V ~{£{{~ Relationship : 4"--C( Home Phone: Business Phone: Mobile Phone 3 a I 71 () S ~ ~ ~~~~~~ ~~~~~~ Doctor's Address or Hospital : ~~~~~~~~~~~~~~~~~~~~~~~~ 2 CITY OF COLLEGE ST A TION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, £°.l ~ V '-.:l{t.,';), am being allowed to participate in City activities. I voluntarily and knowingly execut~ this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers, employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each line) . tdJ1 am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. Q.i I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. ~ shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. 1 __ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents , servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims , demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees , created by, or arising out of the agreement herein designated above and from my participation including, but not limited to , claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death , and/or damage. 'fo~\/further autho rize the City's emp lo yee or agent supervising this activity to sec ure medical care for me in the event of injury. I promise to assume liability for payment, and ho ld harm less the City, its officers, emp lo yees , sponsors , volunteers, or agents , of medic al expenses arising from sai d medical care for said injury and, I further authorize the City to perform criminal history b ackground checks , driving record checks , and/or drug screens when applicab le to the duties , programs , or my participation in activitie s . ':t2t._Jhereby give the City the right to photograph, televi se , film , and sound record my acts, appearances and utterances of me an d to use any descriptive words or names, including my name in conjunction therewith and witho ut limit as to the time , to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films an d sound recording shall be the excl u sive property of the City and I hereby relinqui sh all rights , title, and interest therein. I, the undersigned, have read this release and in demnification and understand all its terms. I execute it vo luntari ly and with full knowledge of its significance. SIGNED~ w. ;? / Signature: ~ ~- day of ~~ , 20 7,, +- Address: (C<>O<'" :?w-~~~ ~. Printed Name: r;\,f--k"'""° v/~~ r In case of emergency, please notify the follow ing: Telephone: __ 1_,_/_~_----=6'--'9:.__'> -/--'-----:t-/_()--'------ Name:-~~~~-----__ f'J~·~--------~.f-~ ____ Relationship : -----'vv_r_<K'--- 1 -=---- Home Phone : ______ Business Phone: ______ Mobile Phone: '71 { -.f: 00 ~3-2-~ ~ Doctor's Name: Office Phone: ----------------------- Doctor's Address or Hospital : ------------------------ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, ~'i.,~ c~l(\I ~ being allowed to participate in City activ1t1es. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments , officers , employees, agents , successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or ve hicles . As consideration for the City of College Station allowing me to participate, I hereby state: (Initial eac h lin e) ~not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and w ill participate without pay and with no expectation of pay or any other benefits from the City. ~with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. .Dl.f~,,,_A....Hgree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. ~rther authorize the City's employee or agen t supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless th e City, its officers, employees , sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks, and/or drug screens when applicable to the duties, programs, or my participation in activities. ~I hereb y give the City the right to photograph , televise, film , and sound record my acts, appearances and utteranc es of me and to use any descriptive words or names, including my name in conjunction therewith and witho ut limit as to the time, to produce and reproduce the same or any part thereof by any method and to u se for any purpose which the City deems proper. All such photo graphs, teletape s, films and sound recording shall be the exclusive property of the City and I her eby relinquish all rights, title, an d interest therein. I, the undersigned , have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. In case of emergency, please notify the follow ing: Name: ------'(~\__._~ -t,-.-::>_;_l_____::_i_fL __ __;~......___L ___ Relationship : ~ ~ Home Phone: _____ Business Phone: _____ Mobile Phone: C\ ~ j "'¥-3 °l <\ oY, ~ Doctor's Name: Office Phone: ~~~~~~~~~~~~~~ ~~~~~~~~- Doctor's Address or Hospital : ~~~~~~~~~~~~~~~~~~~~~~~~ 2 CITY OF COLLEGE-STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, Vtf {I ( h-l--Q W 1 \ , am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments , officers , employees, agents , successors, assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial eac h lin e) ~ Cf,,, I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. P {f.,, I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. f(V I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines , penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. PCL-I agree to indemnify and hold ha·rmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to , claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. f (L. I further authorize the City's employee or agent supervi sing this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors, volunteers, or agents, of medical expenses aiising from said medical care for said injury and, I further authorize the City to perform criminal history background checks, driving record checks, and /or drug screens when applicable to the duties, programs , or my participation in activities. -1-11_ I hereby give the City the right to photograph, televise, film , and sound record my acts, appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and witho ut limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the excl usive property of the City and I hereby relinquish all rights, title , and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance . SIGNED THIS THE _2__,__/ __ day of_ ...... 10___;;1;_;z _____ , 2o:J-~ Signature:~~ ~ Address: 8g0o &v i /Le W{)()J l:/rtv Printed Name: P(A+ '~ l !:., Lw i 5 Telephone: q 71 } )-> -Lf ltt In case of emergency, please notify the following: Name: ~ti\f Jel\J luv1' Relationship: _f1_1_4-\:----- Home Phone: _____ Business Phone: _____ Mobile Phone: 111 ~S-S: 3& ( l Doctor's Name: ---'D~/ _ __,_,S__._/IA'-'-'-'.J...J _"'.:__ ______ Office Phone: ________ _ Doctor's Address or Hospital : ------------------------ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, , am being allowed to participate in City act1v1ties. I voluntarily and knowingly ex ute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers, employees, agents, successors, assigns , sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of Colle ge Station permit and allow me to participate in activities for the City , including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state : (Initial each lin e ) M I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ,l./1-'r I with the intention of binding myself, my heirs, executors, administrators, and ~s, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation . .i../(t. shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas , and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. ) __ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __ I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors , volunteers, or agents , of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks, and/or drug screens when applicable to the duties, programs , or my participation in activities. __ I hereby give the City th e right to photograph, televise , film , and sound record my acts, appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs , teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title , and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE-----day of , 20_. Signature: {if; ~ Printed Name: &tJ "t-to-.'I L'=J In case of emergency, please notify the following: Name: ~I--- Address: ;l.8'1J 3 4rni·)') Gt-, N Telephone: 97t?]-C, '/? -2 f5'.) Relationship: L/ • ·k_ Home Phone: _____ Business Phone: _____ Mobile Phone: 9/q -C. "1&.-?.&fotJ Doctor's Name: Office Phone: ~~~~~~~~~~~~~~ ~~~~~~~~- Doctor's Address or Hospital: ~~~~~~~~~~~~~~~~~~~~~~~~ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, J~~ M.&-..cLe.,.Lvc.J(, am being allowed to participate in City act1v1tles. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments, officers, employees , agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e ) ~I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. j ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. J t-I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. j /'"\ I agree to indemnify and hold harmless the City of College Station , Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs , or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. J /--I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors, volunteers , or agents , of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks, driving record checks, and/or drug screens when applicable to the duties, programs , or my participation in activities. J h I hereby give the City th e right to photograph , televise, film , and sound record my acts, appearances and utterances of me and to use any descriptive words or names , including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the excl usive property of the City and I hereby relinquish all rights, title , and interest therein . I, the undersigned, have read this release and indemnification and understand all its terms. I execute it vo luntarily and with full knowledge of its significance. SIGNED THIS THE !1 ( ff-day of /11 P.....' , 20 .Q j . Signature ~ Addres~lHo Leµ, an-Q r; {/J(\.e~(/.£.F Printed Name: "'-~ Mzd elA~-l( Telephone: s { Q & ~ K L f 8 :J In case of emergency, please notify the following: Name: L Dr,· M~del.Je_(( R I . h" c;-p 6 v s~ e ations 1p : _______ _ Home Phone: S (}JD j) l ~s iness Phone: Mobile Phone: ----------- Doctor's Name: Office Phone: -------------~ --------~ Doctor's Address or Hospital : ------------------------ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, t.11/) 11? /l/Je1 , am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments , officers, employees, agents, successors, assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activities for the City , including but not limited to riding in City owned vehicles . As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehi cles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial eac h lin e) ~I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other ben efits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. cvKA I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas , and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. ~I agree to indemnify and hold harmless the City of College Station, Texas, and/or its I departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contr ibuting cause of the resultant injury, death, and/or damage. ~I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employee s, sponsors , volunteers, or agents , of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks, dri ving record che ck s, and/or drug screens when applicable to the duties , programs , or my participation in activities. ~ I hereby give the City the right to photograph , televise , film , and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time , to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs , teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights, title , and interest therein . I, the undersigned , hav e read this release and indemnification and understand all its terms . I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE __ Z_l __ day of __ ~........,....A__Y _____ , 2o-t"2 . Signature :~ }(~ Printed Name: /vll/;~"1 /< ,di(,;pA/ In case of emergency, please notify the following: Name: A t1u< /{{tit/ Relationship : t2JI CJ~L Home Phone:'?11 Business Phone: ______ Mobile Phone: t??-311~-~/l.5- Doctor's Name: ~//Ml.II> J/u,JJL Office Phone: -~~~~~~~- Doctor's Address or Hospital: ~/3~.Jl~W ___________________ _ 2 CITY OF COLLEGE ST A TION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I ,~ f~~'.-l ~~{(ft 1oef~~pate in City activities . I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishrnent of any and all claims again st the City of College Station, Texas , its departments , officers, employees , agents, successors , assigns , sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e ) /iam not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. ~all fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold harmless the City of College Station, Texas , and/or its departments, officers, agents, servants, employees, successors , assigns, sponsors , or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employ ees , created b y, or arising out of the agreement herein designated above and from my participation including, but not limited to , claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended b y the participant to indemnify and protect the City of College Station and or its d epartments, ag en t s, officers, servants, or employe es from the con sequences of th e neglige nc e of the City and/or its d epartments, agents, officers, servants, or employees , w hether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __ I further autho rize the City's emp loyee or agent sup erv ising this activ ity to secure me dica l care fo r me in the event of injury. I promise to assume liabil ity for payment, an d ho ld harm less th e City, it s office rs, empl oyees, spon sors, v olu nteers, or agents, of medi ca l expe nses arising from sa id me dical car e for sai d inj ury an d, I furthe r authorize the City to perform criminal history backgroun d checks , driving record ch ecks, and/or drug screens when app licab le to the duties, programs , or my participation in activities. __ I hereby give th e City the r ight to photograph, te lev ise, film , and sou nd record m y acts, ap p earances and utterances of me and to u se any d escrip tive words or nam es, including my name in conjun ction therew ith and without li m it as to the tim e, to produce and rep ro duce th e same or any part th ereof by an y method and to u se fo r any purp ose which th e City deems pro per. A ll such photo graphs, teletapes , films an d so und recording sh all b e the ex clu sive p roperty of the City an d I here by re lin qui sh all rights , title, an d interes t th erein. I, the undersigned, have read this re lease an d in demnificatio n an d understan d all its terms. I execute it voluntari ly an d with fu ll knowledge of its significance. SIGN~> 5 ~da y of d1 ~ , 20L2 Signatu riw."'~ Address: ( 'f & ? &4'c (' C ;.-.._ Printed Name: /{..f 4_ l@r ~="'"?.. Telephone: I ~----------~ In cas e of emergency, pleas e notify the follow ing : Name: ___________________ Relationship : _______ _ Home Phone: Business Phone: M obile Phone: ----------------- Doctor's N am e: Office Phone: -------------~ --------~ Doctor's Address or Hospital : _______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, KH.7. 4,-!ofZ.. , am being allowed to participate in City activities. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas, its departments, officers, employees, agents, successors, assigns, sponsors and volunteers assisting in City activities, which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation , I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles . As consideration for the City of College Station allowing me to participate, I hereby state : (Initial each lin e ) --1tL.__ I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. ~ I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employe es, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents , servants, or employees , created b y, or arising out of the agreement herein designated above and from my participation including, but not limited to , claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __ I further authorize the City's emp loyee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors, volunteers , or agents , of medical expenses arising from sai d medical care for said injury an d , I further authorize the City to perform criminal history b ackground checks , driving record checks, and/or drug screens when applicable to the duties, programs , or my particip ati on in activities. __ I h ereby give the City the right to photograph, te levise, film , and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limi t as to the time, to produce and reproduce the same or any part thereof by any method and to u se for any purpose which the City deems proper. All such photographs , teletapes , films and sound recording sh a ll be the exclu sive property of the City and I h ere by relinqui sh all rights , title , and interest therein. I , the undersigned, have read this release and indemnification and understand all its terms. I execute it vo luntarily and with full knowledge of its significance. SIGNED THIS THE Z ( /day of __ /11~~------' 20 ZZ.... Signature: /:'5 2,q= Address:_l_2.._Cl~2_0_f?~/2...._57~--- Printed Name: ~1 J.A,.jP fz._ Telephone: "t ? 2 -2 2 't -G. o '7 2' In case of emergency, please notify the following: Name: LJlo/ Relationship : µ./, /!e__ Home Phone:9 !j-777-Jt.W Business Phone: _~ _____ Mobile Phone: ~ Doctor's Name : /.A..1n·-'Y'I <;rh-/!4-, . Office Phone: ~-------- Doctor's Address or Hospital : -=.S:~6~o_'7~"1~-1=-· W~_f;i---'-", Je~~------------- 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, /o1:,ed ~~ S2... , am being allowed to participate in City actlv1t1es. I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the ex tinguishment of any and all cl aims against the City of College Station, Texas , its departments , officers , employees , agents , successors , assigns, sponsors and volunteers assistin g in City activities , which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind , I hereby request that the City of College Station permit and allow me to participate in activitie s for the City, including but not limited to riding in City owned vehicles. As part of my participation , I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e ) ~am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay 7 exp ectation of pay or any other benefits from the City. I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. __ I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees , created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees , whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. __ I furth er authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors , volunteers, or agents , of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driv ing record checks, and/or drug screens when applicable to the duties, programs , or my participation in activities . __ I hereby give the City the right to photograph, televise , film , and sound record my acts , appearances and utterances of me and to use any descriptive words or names, including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights , title , and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. SIGNED THIS THE j2 \ Signature: _ _.g.__-=----~----'--------- Printed Name: £ofoe-rf-~o 5 ce__ , day of _M_t:l_y ______ , 20 ~ In case of emergency, please notify the followi ng: Name: __ 17l~_"i_n_S~t!'_t7_""-_~frl~~'°---cJc.~_a _____ Relationship: r -/'t!!!!~ Home Phone: _____ Business Phone: _____ Mobile Phone:J/J. T 17. ~ )/ Doctor's Name: Office Phone: -------------~ --------- Doctor's Address or Hospital : __ S __ of-__ ~ ___ Z:::_~t'r~5~~~~~--------- 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS r,T.J(~, !#A--, am being allowed to participate in City activ1t1es . I voluntarily and knowingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments , officers, employees , agents, successors, assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation , I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate , I hereby state: (Initial each lin e ) K I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. _fr I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. WI shall fully defend, protect, indemnify, and hold harmless the City of College ~n, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. ff-I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or arising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the par ticipant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. ___lJ_ I further authorize the City's emp loyee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees, sponsors, vo lunteers , or agents, of medical expenses arising from said medical care for said injury and , I further authorize the City to perform criminal history background checks, driving record checks , and/or drug screens when applicable to the duties , programs , or my participation in activities. -#+hereby give the City the right to photograph, televise, film , and sound record my acts, appearances and utterances of me and to u se any descriptive words or names , including my name in conjunction therewith and without limit as to the time, to produce and reproduce the same or any part thereof by any method and to use for any purpose which the City deems proper. All such photographs, teletapes , films and so und record ing shall be the exclusive property of the City and I hereby relinquish all rights , title , and interest therein. I, the undersigned, have read this release and indemnification and understand all its terms . I execute it vo luntarily and with full knowledge of its significance. SIGN~ ]}f}? T~E __ v_I _day of fltl ~ , 20 "")/ ?- Signature: \)f/~ Address: 0 OJ t Qi1~ 61 I Printed Name:_:=I:~.e.-~~~-bhi..----'~~-' _lr/v.-___ Telephone: q 1. q ).... 2 c; / l/ 7, ~ c_r In case of emergency, please notify the following : Name:kdJ, ~' J~ Relationship : -~'----'--~----- Home Phone: _____ Business Phone: _____ Mobile Phone: fj? 7 l.t 7 6 0 / / l Doctor's Name : Office Phone: ----------------------- Doctor's Address or Hospital : _______________________ _ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, ~CU 1 1~'Nl... am being allowed to participate in City activities. I voluntarily allilOWingly execute this release and indemnification with the express intention of effecting the extinguishment of any and all claims against the City of College Station, Texas , its departments , officers , employees , agents , successors , as signs , sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above . Being over the age of 18 years and being of sound mind , I hereby request that the City of Coll ege Station permit and allow me to participate in activities for the City , including but not limited to riding in City owned vehicles . As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate, I hereby state: (Initial each lin e) ~ I am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee , I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. ~ I with the intention of binding myself, my heirs, executors, administrators, and assigns, do hereby expressly release and discharge, all claims, demands, actions, judgments, and executions, which I ever had, or now have or may have, or which my heirs, executors, administrators, or assigns may have, or claim to have, against the City of College Station, and/or its departments, its agents, officers, servants, successors, assigns, sponsors, volunteers, or employees, created by, or arising out of personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, that sequence of events which occur from the agreement as herein designated above, or which may arise directly or indirectly from the performance of or created by or arising out of my participation during times of this indemnity agreement. I hereby personally accept and assume all risk and responsibility for any harm, injury, or damage, to myself or my property, while I am on City owned property and while performing activities for my participation. ~ I shall fully defend, protect, indemnify, and hold harmless the City of College Station, Texas, and/or its departments, agents, officers, servants, employees, successors, assigns, sponsors, or volunteers from and against each and every claim, demand, or cause of action and any and all liability, damages, obligations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense of the City of College Station, Texas, and/or its departments, agents, officers, servants, or employees, including, without limitation, personal injuries and death in connection therewith which may be made or asserted by myself, my agents, my successors, my assigns, or any third parties on account of, arising out of, or in any way incidental to or in connection with the performance of this agreement and from my participation. ~I agree to indemnify and hold harmless the City of College Station, Texas, and/or its departments, officers, agents, servants, employees, successors, assigns, sponsors, or volunteers from any liabilities or damages I may suffer as a result of claims, demands, costs, or judgments against the City and/or, its departments, its officers, agents, servants, or employees, created by, or a r ising out of the agreement herein designated above and from my participation including, but not limited to, claims and damages arising in whole or in part from the negligence of the City of College Station and/or the parties to this agreement. It is understood and agreed that the indemnity provided for in this section is an indemnity extended by the participant to indemnify and protect the City of College Station and or its departments, agents, officers, servants, or employees from the consequences of the negligence of the City and/or its departments, agents, officers, servants, or employees, whether that negligence is the sole or contributing cause of the resultant injury, death, and/or damage. ~I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to ass ume liability for payment, and hold harmless the City, its officers, employees, sponsors, volunt eers, or agents , of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks , driving record checks , and/or drug screens when applicable to the duties , programs, or my participation in activities. ~ I hereby give the City the right to photograph, televise, film , and sound record my acts, appearances and utterances of me and to u se any descriptive words or names , including my name in conjunction therewith and wi thout limit as to the time, to produce and reproduce the same or any part thereof by any method and to us e for any purpose which the City deems proper. All such photographs, teletapes , films and sound recording shall be the exclusive property of the City and I hereby relinquish all rights , title , and intere st therein . I, th e undersigned, have read this rele ase and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. SIGNEDTHISTHE g\ dayof t:\a1tr ,20_»- Signature:.~~ ~.D Address : St.tOQ S;\?Yl°'O~ Printed Name: ~1r1J"en~ ~&J lephone: 4~S · S'j Q · 2 S tf S In case of emergency, please notify the following: Name: Scoi1 UllWfd rol Relationship: \JusbaAtVl . \p\ l (p Home Phone: irf:)·~~/10 · Business Phone: _____ Mobile Phone: ~/M.:\.......Q Doctor's Name: Ut , t\t!tt\tt.PMJ ~ Office Phone: LlP-f\ ?ed S · Doctor's Address or Hospital: _______,,\.,,.1 ..... fi_.A~------------------ 2 CITY OF COLLEGE STATION RELEASE AND INDEMNIFICATION FOR PARTICIPANTS I, u , },;i Js;. , am being allowed to participate in City activities. I voluntarily a d knowingly ex cute this release and indemnification with the express intention of effecting the extinguishment f any and all claims against the City of College Station, Texas , its departments , officers, employees , agents , successors, assigns, sponsors and volunteers assisting in City activities , which may result from the agreement as herein designated above. Being over the age of 18 years and being of sound mind, I hereby request that the City of College Station permit and allow me to participate in activities for the City, including but not limited to riding in City owned vehicles. As part of my participation, I will be allowed access to various City facilities and may be allowed to use certain equipment or vehicles. As consideration for the City of College Station allowing me to participate , I hereby state : (Initial each line) / f«-1 am not an employee of the City of College Station and all the activities I perform will be as a participant. As I am not an employee, I am a participant and will participate without pay and with no expectation of pay or any other benefits from the City. N 0 ~ I with the intention of bindin myself, my h rs, executors, administrators, and assigns, do hereby expressly release and ·scharge, al claims, demands, actions, judgments, and executions, which I ever had, or now ave or ay have, or which my heirs, executors, administrators, or assigns may have, or cla to ave, against the City of College Station, and/or its departments, its agents, office , servants, successors, assigns, sponsors, volunteers, or employees, created by, or ar, ing out of personal injuries, known or unknown, and injuries to property, real or pe onal, ·caused by or arising out of, that sequence of events which occur from the a eeme t as herein designated above, or which may arise directly or indirectly from the rf orman of or created by or arising out of my participation during times of this inde •ty agreem t. I hereby personally accept and assume all risk and responsibility fo any harm, inj ry, or damage, to myself or my property, while I am on City owne property and w · e performing activities for my participation. {\{10 ~ I shall fully defend, protect, · demnify, a hold harmless the City of College Station, Texas, and/or its departments, gents, o 1cers, servants, employees, successors, assigns, sponsors, or volunteers from and gains each and every claim, demand, or cause of action and any and all liability, damages, bl' ations, judgments, losses, fines, penalties, costs, fees, and expenses incurred in defense o e City of College Station, Texas, and/or its departments, agents, officers, servants, o loyees, including, without limitation, personal injuries and death in connection erew1 which may be made or asserted by myself, my agents, my successors, my ass· ns, or an third parties on account of, arising out of, or in any way incidental to or in c nnection wit the performance of this agreement and from my participation. 1 A/ Q__ I agree to indemnify and h d harmless the c· of College Station, Texas, and/or its departments, officers, agents, s vants, employ s, successors, assigns, sponsors, or volunteers from any liabilities or mages I ma suffer as a result of claims, demands, costs, or judgments against the City nd/or, its partments, its officers, agents, servants, or employees, created by, or arising ou f the a eement herein designated above and from my participation including, but not limi d to claims and damages arising in whole or in part from the negligence of the City o ollege Station and/or the parties to this agreement. It is understood and agreed that e indemnity provided for in this section is an indemnity extended by the participant to i e ify and protect the City of College Station and or its departments, agents, officers, s rvant or employees from the consequences of the negligence of the City and/or its dep rtments, agents, officers, servants, or employees, whether that negligence is the sole or ontributing cause of the resultant injury, death, and/or damage. /~I further authorize the City's employee or agent supervising this activity to secure medical care for me in the event of injury. I promise to assume liability for payment, and hold harmless the City, its officers, employees , sponsors, volunteers, or agents, of medical expenses arising from said medical care for said injury and, I further authorize the City to perform criminal history background checks, driving record checks, and/or drug screens when applicable to the duties, programs, or my participation in activities. J..f.Q_ I hereb y give the City the righ to pho graph, televise, film, and sound record my acts, appearances and utterances of me and to se ny descriptive words or names, including my name in conjunction therewith and without lim1 s to the time, to produce and reproduce the same or any part thereof by any method and to se or any purpose which the City deems proper. All such photographs, teletapes, films and und r ording shall be the exclusive property of the City and I hereby relinquish all rights, titl and intere therein. I, the undersigned, have read this release and indemnification and understand all its terms. I execute it voluntarily and with full knowledge of its significance. -+--+----day of /'vf fly , 20 Z ?- Address: 4 ()1J &Ja(/e~ {Jr, ~~ "TX' 77 fi:f Printed Na '---+--=--:'---..=..,.--+----Telephone: f 7 C/ l& CJ 8 734- In case of emergency, pleas notify tile following: Name: [/a~ Vy111 I Relationship: _fµ_r _~-~----6. Lr~J7 Home Phone: 171/'flt/~/ Business Phone: l/7f"Zt,,~879 Mobile Phone: f7f 3U4178 Doctor's Name: bcvv-ft.. Jr/ tJ rft111 I Office Phone: --------~ Doctor's Address or Hospital:------------------------