RELEASE OF LIABILITY READ CAREFULLY - THIS AFFECTS YOUR LEGAL RIGHTS

The Pole Vault Clinic of Jordan Chase is the senior project of the Lynnwood High School (LHS) student, Jordan Chase. The mission of the Pole Vault Clinic of Jordan Chase is to educate beginners in the fundamentals of pole vault and to rene the technique of more experienced athletes. The facilities of the Edmonds Woodway High School (EWHS) Stadium will be used. These include the pole vault pit, runway, and poles of the mentioned campus. Coach Brianne Sturm of EWHS and former Coach James Turow (EWHS) will supervise the proceedings. In exchange for participation in the activity of pole vaulting organized by Jordan Chase and the use of the property and facilities of the Edmonds School District, I agree for myself and (if applicable) for the members of my family, to the following: 1. I understand that Jordan Chase (founder and instructor of The Pole Vault Clinic of Jordan Chase) is a student and a minor, and further agree to follow any oral instructions or directions given by the The Pole Vault Clinic of Jordan Chase, and representatives or agents of The Pole Vault Clinic of Jordan Chase. 2. I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge The Pole Vault Clinic of Jordan Chase for injury, loss or damage arising out my or my familys use of or presence upon the facilities of the Edmonds School District operated by the Pole Vault Clinic of Jordan Chase, whether caused by the fault of myself, my family, The Pole Vault Clinic of Jordan Chase, associating parties (including the Edmonds School District, Coach Bri Sturm, Coach James Tutrow, Martin F Chase, Soo H Chase, and Jordan Chase), or other third parties. 3. I agree to indemnify and defend The Pole Vault Clinic of Jordan Chase and associating parties (including the Edmonds School District, Coach Bri Sturm, Coach James Tutrow, Martin F Chase, Soo H Chase, and Jordan Chase), or other third parties against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my familys use of or presence upon the facilities of the Edmonds School District operated by The Pole Vault Clinic of Jordan Chase. 4. I agree to pay for all damages to the facilities of the Edmonds School District operated by the Pole Vault Clinic of Jordan Chase caused by my or my familys negligent, reckless, or willful actions 5. I consent to the participation of my son/daughter ,______________________, in pole vaulting and agree on behalf of the above minor to all of the terms and conditions of this Agreement. By signing this Release of Liability, I represent that I have legal authority over the custody of _____________________. 6. Any legal or equitable claim may arise from participation in the above shall be resolved under Washington law. I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.

Dated: _____________________ Signature of Parent or Guardian: _______________________________ Signature of participating athlete and/or minor: _________________________________ EMERGENCY CONTACT INFORMATION. In case of an emergency, please call _______________________ (Relationship: ___________________) at _______________________ Ext. _______________________(Day), or _____________________Ext. ______________________(Evening).