Fillable Printable Liability Release Agreement

Liability Release Agreement

LIABILITY RELEASE AGREEMENT

Minor's Legal Name (Print) (If there is more than one child per family

participating, please provide their legal name(s)):

, , , ,

(collectively referred to as “Minor”) wishes to participate in (“Activity”) sponsored by

K12 Inc., a Delaware corporation ("K12").

K12 and the undersigned parent or legal guardian of Minor agree that the Activity may pose risks,

including possible illness, injury, as well as similar and dissimilar risks (“Risks”). The undersigned is fully

aware of the Risks and other hazards inherent in the Activity and is participating in the Activity voluntarily

and assumes the Risks and all other risks of loss, damage, or injury that may be sustained while participating

in the activity.

K12 makes no representations or claims as to the condition or safety of the land, structures, transportation or

surroundings that may be involved in the Activity, whether or not owned, leased, operated or maintained by

K12. It is understood that K12 does NOT provide any insurance coverage for the Minor's person or property,

and Minor's parent (s) or guardian (s) acknowledge that they are responsible for the Minor's safety and the

Minor's own health care needs, and for the protection of the Minor's property.

In exchange for allowing the Minor to participate in these K12 Activities, the Minor, by and through

the undersigned, the undersigned, and their respective heirs, personal representatives and estates agree(s)

to release from liability and hold harmless K12 and any agent, officer or employee of K12 acting within

the scope of their duties for any injury to the Minor's person or damage to the Minor's property. I authorize

K12 to take any action, including seeking medical care, necessary in its judgment if I am not present or

reachable in the event of an emergency. The undersigned acknowledges that as a part of this Release he or she

shall be 100% liable to pay for all medical expenses resulting or to result from any injury incurred during, or

as a result of, participation in the Activity.

If any term of this agreement or the application to any person or circumstance shall, to any extent, be invalid

or unenforceable, the remainder shall not be affected thereby, and each and every remaining term

of this agreement shall be valid and enforced to the fullest extent permitted by law. In the event of any

need to enforce this agreement, K12 shall be entitled to its attorney fees and costs. This agreement will

be governed by Virginia law.

I, the undersigned, state that I am the parent or legal guardian of the Minor. I have fully read and

understand the above terms and conditions and that they apply to said Minor and to myself, and that

no oral representations, statements or inducements apart from the foregoing written agreement have

been made to the undersigned. This document is binding on myself, the said Minor, and any person

suing on behalf of said Minor.

Address:

Parent/Guardian Name (Please print)

Signed

Date