FORM: H3P-1

- S A M P L E F O R M -
Waiver, Indemnification and Hold Harmless Agreement

In consideration of having the benefit of the use of the _____________________ facilities at ____________________________ (location), of the ___________________________ School District, the undersigned organization, for itself and its officers, directors, employees, agents and members, hereby waives any claim for any personal injury, property damage, or other loss, expense or other damage that any of them may incur as a result of or related to such use, and does further hereby agree to indemnify and hold the above District and the ____________________________ Supervisory Union and their directors, officers, employees, agents and contractors, harmless for and from any claim, demand, action, liability, expense or damage incurred as a result of or relating to such use.

ORGANIZATION:

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BY:

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