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PARTICIPANT/PARENT/GUARDIAN WAIVER AND INDEMNITY AGREEMENT

RUTHERFORD TUTORIAL ACADEMY

OF MIDDLE TENNESSEE HOME EDUCATION ASSOCIATION

2010-2011 CLASSES/SPORTS/SOCIAL/LUNCH

PARTICIPANT___________________________________________

In consideration of your accepting our child or children for participation in the above named program, activities and sports, I hereby, for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages that I may have against the above named organization and its agents, employees, representatives, successors and assigns for any and all injuries suffered by myself or my child or children that rise out of the above-named program activities and sports sponsored by the above named organization.

I warrant that I have the right to authorize the foregoing and do hereby agree to hold the above-named organization harmless of and from any and all liability of whatever nature which may rise out of or result from such participation.

For the consideration stated above, I further agree that in the event that my child or I should make any claim against the above named organization for damages arising out of the above-named program, activities or sports, I will personally indemnify, defend, and hold harmless the organization and its agents, employees, representatives, successors, and assigns against any and all loss and damage occasioned thereby, including attorney’s fees.

I have read and understand the Agreement and have willingly placed my signature below as evidence of my acceptance of all the conditions contained herein.

Signature: Participant_______________________________Date_________

Parent:___________________________________________Date_________

Guardian:_________________________________________Date_________

Signatures of all persons that have joint legal custody of these minors are required.