Minor Participant Liability Waiver and Release Form
Event Name: Executive Board Nomination Form - 2025-2026
LPS of USA – Election Forms
Participant Information Name:
<Name> Date of Birth:
<DateOfBirth> Parent/Guardian Name:
<ParentName> Relationship to Participant:
<RelationshipToParticipant> Address:
<Address> City, State, ZIP:
<City> - <Zipcode> Phone:
<Phone> Email:
<Email>
Acknowledgment and Assumption of Risk
I, the undersigned parent or legal guardian of the minor participant named above, acknowledge that participation in the event involves certain risks, including but not limited to personal injury, property damage, or other harm. I voluntarily assume all such risks on behalf of my child and understand that the event organizers, sponsors, and affiliates assume no responsibility for any injury or loss.
Release and Waiver of Liability
In consideration of my child’s participation in the event, I hereby release, waive, and discharge the event organizers, sponsors, venue, employees, volunteers, and affiliates from any and all liability, claims, demands, or causes of action arising out of or related to any loss, injury, or damage sustained by my child during the event.
Medical Authorization
In the event of an emergency, I authorize event staff to obtain medical treatment for my child if I am unavailable. I assume full financial responsibility for any medical expenses incurred.
Photo/Media Release
I grant permission for my child’s photograph, video, or likeness to be used for promotional and marketing purposes by the event organizers without compensation.
Acknowledgment of Rules and Conduct
I agree that my child will follow all event rules and instructions provided by event staff. Failure to comply may result in removal from the event without refund.
Indemnification
I agree to indemnify and hold harmless the event organizers, sponsors, and affiliates from any claims, losses, damages, or liabilities arising from my child's participation.
Parent/Guardian Consent and Agreement
By clicking the button below, I acknowledge that I have read, understood, and voluntarily agree to the terms of this waiver on behalf of my child. I understand that my electronic submission constitutes a legal signature.
