Indemnity and Limitation of Liability Michaelhouse D Block Hike 2018 NOTE: Reference in this indemnity to the plural also include the singular. Please scan and email the completed form to joamor@michaelhouse.org We, the undersigned parents/ guardians of (Pupil’s name)(“the Pupil”) by our signatures hereto: Consent, to the participation of the Pupil in the D Block Hike excursion. Are aware of the statement by Michaelhouse that it will endeavour to take such steps as it may be reasonably required in the circumstances, to do what it can to keep the Pupil out of harm and free of loss, taking into account the circumstances of the D Block Hike. Recognise that participation in the D Hike has inherent dangers which dangers may include serious injury or death in and to the Pupil. Confirm and agree that the point highlighted in 3 above has been brought to our attention by Michaelhouse in accordance with the provisions of the Consumer Protection Act. Jointly and severally waive any and all of our claims and that of the Pupil and indemnify Michaelhouse and its employees, agents, contractors, subcontractors or assigns against any claim of the Pupil or ourselves, arising out of fatality, illness, loss, damage to property or bodily injury in the knowledge and on the understanding that Michaelhouse will take all reasonable precautions for the safety and welfare of the Pupil and associated property as set out above. SIGNED at this day of 2018. 1. WITNESS 1 PARENT or LEGAL GUARDIAN 1 (name and signature please) (name and signature please) 2. WITNESS 2 PARENT or LEGAL GUARDIAN 2 (name and signature please) (name and signature please) Email to
Indemnity and Limitation of Liability Michaelhouse D Block Hike 2018 NOTE: Reference in this indemnity to the plural also include the singular. Please scan and email the completed form to joamor@michaelhouse.org We, the undersigned parents/ guardians of (Pupil’s name)(“the Pupil”) by our signatures hereto: Consent, to the participation of the Pupil in the D Block Hike excursion. Are aware of the statement by Michaelhouse that it will endeavour to take such steps as it may be reasonably required in the circumstances, to do what it can to keep the Pupil out of harm and free of loss, taking into account the circumstances of the D Block Hike. Recognise that participation in the D Hike has inherent dangers which dangers may include serious injury or death in and to the Pupil. Confirm and agree that the point highlighted in 3 above has been brought to our attention by Michaelhouse in accordance with the provisions of the Consumer Protection Act. Jointly and severally waive any and all of our claims and that of the Pupil and indemnify Michaelhouse and its employees, agents, contractors, subcontractors or assigns against any claim of the Pupil or ourselves, arising out of fatality, illness, loss, damage to property or bodily injury in the knowledge and on the understanding that Michaelhouse will take all reasonable precautions for the safety and welfare of the Pupil and associated property as set out above. SIGNED at this day of 2018. 1. WITNESS 1 PARENT or LEGAL GUARDIAN 1 (name and signature please) (name and signature please) 2. WITNESS 2 PARENT or LEGAL GUARDIAN 2 (name and signature please) (name and signature please) Email to
DBlockHike2018-Indemnity-Form.docx