Child's Name *
Child's Name
Vanpool Waiver of Liability *
Agreement, Release, Assumption of Risk, and Waiver of Liability for Participation in a Carpool -- Whereas, the undersigned parent(s) and/or natural guardian(s) of above named child, desire that said child participate in a carpool for transportation to and from Primrose Hill School and -- Whereas such carpooling shall begin on September 15, 2015 and end on June 9, 2016; and -- Whereas said carpool shall be driven by the following drivers (hereinafter referred to a Drivers): -- TAKKEN WISH -- Now, therefore, for and in consideration of the benefits that the undersigned and my/our child will receive as participants in this carpool, I/we, individually and on behalf of my/our child assume all risks and waive any liability of any nature whatsoever against Drivers, and agree to indemnify and hold Drivers harmless, with respect to any and all actions, claims or demands (including attorney’s fees) that may accrue or be made or brought by the undersigned, someone on the behalf of the undersigned, said child, or someone on behalf of said child, against Drivers, which arise out of or is in connection with my child's participation in this carpool, whether such claim, demand or action is the result of the negligence of Drivers or otherwise. I/we hereby release, waive, forever discharge Drivers from any and all claims, demands, damages to or loss or destruction of any property, or claims or damages that result from loss of life, which the undersigned or said child may suffer while participating in said carpool or arising out of or in connection with such participation, whether such claims, demands, or damages are the result of negligence of Drivers or otherwise. -- I further agree to waive any and all future claims against Primrose Hill School or its designated representatives and release the aforementioned from any and all liability for any loss, damage, expense or injury, including death, that my/our child may suffer resulting from or arising out of any aspect of my/our participation or my/our child’s participation in this carpool. I have read and understand this Agreement and I am aware that by signing this Agreement, I am waiving certain legal rights which my heirs or I may have against Primrose Hill School or its designated representatives. -- By signing this waiver, I/we agree and acknowledge that I/we may be giving up important legal rights and remedies available to me/us individually and/or my/our child. I/we have read the foregoing release, waiver, assumption of risk and indemnity agreement and fully understand the terms contained therein and sign this document freely and without inducement. I/we hereby verify the information submitted is true and correct. Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. -- Electronic Signature Agreement. By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions.
Print Name *
Print Name
Date *
Date