| The undersigned parent of __________________________________, ___________________________, _______________________________, _______________________________, _____________________, (children for whom I am the guardian and/or parent and whom I am homeschooling), does hereby agree that any participation in activities coordinated by Homeschool-Blessings, will be solely at my own risk. This release applies to any and all children under my supervision, including both home schooled children and non-home schooled children. I also agree to hold Homeschool-Blessings Board of Directors and its members harmless for any and all personal injuries to myself and to any and all children under my supervision, (both home school and non-home schooled), as well as, any property damage sustained during any Homeschool-Blessings activities. As an un-incorporated voluntary association, I am aware that Homeschool-Blessings can neither sue nor be sued. I do also agree to hold any facility or organization that provides its facility for the use of Homeschool-Blessings activities, (including but not limited to any home or buildings that meetings are held in) harmless for any personal injury to myself or any children under my supervision (both home schooled an d non-home schooled), as well as, property damage, sustained as a result of negligence of the facility or organization providing the facility for Homeschool-Blessings activities. I do agree that such activities will be solely at my own risk, both for myself and the children under my supervision. This release shall be effective for the 2011-2012 school year. Member Signature: __________________________________________________________ State of Florida County of Pasco And known to me personally - or - presented ______________________________ identification in proof to be the person described in and who executed the above Liability Release and acknowledged to and before me that he/she executed said instrument for the purpose therein expressed. Witness my hand and Official Seal, this _________ day of ____________, 20______. ____________________________________________ Notary Public State of Florida |
| HOMESCHOOL-BLESSINGS "Capturing Life's Blessings Through Home Schooling" 2011-2012 LIABILITY FORM |