Release & Assumption of Risk – Lewiston Auburn Senior College

RELEASE AND ASSUMPTION OF RISK FORM

Your Name

Address

a member of Lewiston Auburn Senior College, Inc., acknowledge, declare and agree as follows:

I have agreed to participate in the LASC Club(s):

The Outsiders Outside Activity

from 7/1/2026 to 6/30/2027, and in consideration of being permitted to participate in this activity, do voluntarily execute this “Release and Assumption of Risk” on behalf of myself, my heirs and next-of-kin, my personal representatives and my estate.

I acknowledge that I have been fully informed of the nature, scope and demands of the program and I understand that this activity may include other similar activities that could involve risk.

I accept and assume full responsibility for all harm and injury, of every nature, including death, which may occur to me or which I may suffer, and for all damages or loss to any personal property owned by me while I am participating in this activity and, in furtherance thereof, I agree to indemnify and hold harmless Lewiston Auburn Senior College, Inc. from and against any and all claims, demands, actions or causes of action, on account of damage to my personal property, or my personal injury, or death, which may occur or result directly or indirectly from my participation in this activity, and which are not the result of this negligent act or omission of Lewiston Auburn Senior College, Inc.

I understand that it is not the purpose of this activity or the responsibility of Lewiston Auburn Senior College, Inc. that safety rules and regulations be taught but only that reasonable safety standards be adhered to and agreed to by all participants. I acknowledge that Lewiston Auburn Senior College, Inc.’s agents will not be responsible for administering any required first aid, treatment or medication to me.

I declare that I am able to physically withstand and cope with the indicated rigors of this activity.

I request that this “Release and Assumption of Risk” be construed and interpreted pursuant to the laws of the State on Maine, and if any portion thereof is held invalid, I request the remainder continue in full force and effect.

I declare that I completely understand and have fully informed myself to the terms and conditions of this “Release and Assumption of Risk” by having read it: or having it read to me, before signing.

DIgital Signature

Date

Release &
Assumption of Risk

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