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Indiana FFA Leadership Center
Challenge Course
Release, Assumption of Risk and Responsibility: In consideration of, and in recognition of the inherent
risks of the activity associated with the use of the Indiana FFA Leadership Center Challenge Course, I and/or on
behalf of any minor children for which I am responsible, agree, on behalf of myself, my/ours heirs representatives,
successors, facilitators, executors, and administrators, to hereby release, wave, discharge and agree not to
sue the Indiana FFA Foundation or the Indiana FFA Leadership Center , its officers, directors, facilitators, and
employees from any and all claims or demands, obligations and/or causes of action of any nature
whatsoever which I may have against the Indiana FFA Foundation, the Indiana FFA Leadership Center, its officers,
directors, facilitators, and or employees, on account of any personal injury, property damage, or accident of any
kind, arising out of or in any way connected with the use of the Indiana FFA Leadership Center Challenge Course or
equipment, whether my/our use is supervised or unsupervised and I/we agree to indemnify and hold harmless the
persons or entities mentioned in this paragraph, any and all liabilities of claims made by other individuals or
entities as a result of my/our actions.
I further certify, acknowledge and agree on behalf of myself and/or minor children for whom I am
responsible, that I am physically and mentally capable of participating in that activity and/or use the
equipment. I recognize that because of the potentially hazardous nature of this activity, and an injury may
be sustained. I/we assume the risks for accidents or injuries caused by negligence of my/our actions.
I have signed this agreement to allow myself/my children to participate on the Indiana FFA Leadership Center
Challenge Course.
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User Signature
__________________________________
Printed Name
_____________
Date
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Parent Signature
__________________________________
Printed Name
_____________
Date
Photographic Release
I hereby grant the Indiana FFA Leadership Center permission to use the name of ________________ in a
public document and likewise grant aforementioned program permission to take photographs, video
recordings, and/or sound recordings of ____________________. I grant the Indiana FFA Leadership Center
permission to use negatives, prints, motion pictures, video tapings, or any other production of the same for
educational and promotional purposes in manuals, newsletters, flyers, reports, on the World Wide Web, or
any other manner deemed necessary.
I declare that I read and understand the contents of the RELEASE, ASSUMPTION OR RISK AND
RESPONSIBILITY and PHOTOGRAPHIC RELEASE and am voluntarily signing this release, irrevocably
committing my heirs and myself.
I have signed this agreement to allow myself/my children to be photographed or videotaped on the
Indiana FFA Leadership Center Challenge Course.
__________________________________
User Signature
___________________________________
Printed Name
____________
Date
__________________________________
Parent Signature
___________________________________
Printed Name
____________
Date