LIABILITY AND HOLD HARMLESS AGREEMENT. Individually and on behalf of the Participant, I do hereby release, acquit, hold harmless and forever discharge the church, it’s agents, servants, representatives and employees, and all persons, natural or corporate, in privity with them or any of them, from any and all claims or causes of action of any kind whatsoever, including but not limited to actions, suits and/or claims for any bodily injuries, death or property damage sustained by either the Undersigned or the Participant arising from or related to Participant’s participation in any trip, activity or event (including travel to and from such activities or events).
LIABILITY AND HOLD HARMLESS AGREEMENT. Applicant hereby agrees to be responsible for any damages sustained by any land, building, furniture or equipment because of the occupancy of the premises. It is further agreed that all applicable rules, regulations and policies of the school district governing board will be adhered to as well as enforced. Applicant further agrees to indemnify and save harmless the Upland Unified School District, its officers and employees from and against any liabilities imposed upon said school district which result as a consequence to the performance of this agreement. Upon request we will file with the District business office prior to use a Certificate of Insurance naming the Upland Unified School District as an additional insured on our organization’s liability insurance policy. It is agreed and understood that ‘s members, volunteers, employees and contractors are agents of and not of the District. Authorized Representative’s Signature Building or Facility Requested School Baldy View Purpose or Nature of Use es No Yes No Anticipated No. of Will Admission fees be charged or Y Will meetings or use be nonexclusive Attendance: collections or donations accepted? and open to the public? Net Proceeds to be used for: Date(s) and Times(s) requested: Date Hrs from M to M Date Hrs from M to M Date Hrs from M to M Date Hrs from M to M Regular Weekly or Monthly Meeting Beginning Date Ending Date Sketch of seating or stage arrangement desired: Requests for Special Equipment: Risers # Chairs P.A. System Flags Piano Lectern Projection Equipment # Tables Other Requests for Cafeteria Uses Do not write below this line Use for meeting purposes? Yes No Facility Clearance: Are refreshments to be served? Yes No Auditorium Library Special School Personnel Requested Cafeteria Gymnasium Multi-Purpose Room Do not write below this line Approved Not Approved Rental Fee Salary Other $ Exempt $ $ Use is not permitted until applicant has received a fully signed approval form. Total $ Principal or Representative Date Paid , 20 Business Office Approval UPLAND UNIFIED SCHOOL DISTRICT STATEMENT OF INFORMATION Pursuant to Ed Code 38130-38138, and Upland Unified School District’s Board Policy 1330, the following statement of information has been read and agreed upon by the applicant / organization applying for a use of facility with the Upland Unified School District.
LIABILITY AND HOLD HARMLESS AGREEMENT. The Customer must sign and submit the attached "Hold Harmless Agreement" as a part of this facility reservation application prior to the use of any LIU Facilities.
LIABILITY AND HOLD HARMLESS AGREEMENT. I, on behalf of my Child, understand and agree that Releasees assume no responsibility for any injury or damage which might arise out of or in connection with such authorized emergency medical treatment.
