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City of Cleveland

100 North Street, PO Box 1439, Cleveland, MS, 38732, US




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Indemnification and hold Harmless Agreement

Whereas, registered per this registration form, all will be allowed to participate in the program provided and supervised by the City of Cleveland Park Commission.  As the parent or guardian of the minor child(ren) registered per this registration form, I acknowledge and agree to the following:

NOW, THEREFORE,  FOR AND IN CONSIDERATION of the benefits and privileges extended to said participants and the undersigned by the City of Cleveland, and hereby agree to indemnify and hold harmless the City of Cleveland, Mississippi, the City of Cleveland Park Commission, their agents, sponsors, directors, officers, officials, advertisers, workers and employees, whether paid or volunteer, and any other person or persons involved with the event from any and all claims and liabilities for any kind, character or description for damages or other losses arising out of or claimed to arise out of or by virtue of said minor’s participation in the aforesaid program. This is to include but not limited to all injuries, disabilities, loss of property or damage to person due to your child or ward’s participation.  It is understood and agreed that this Indemnification and Hold Harmless Agreement applies to all costs incurred by any person covered by the terms of this Indemnification and Hold Harmless Agreement, including cost of defense and attorney fees.  I have read this release of liability and assumption of risk, fully understand its terms, understand that I have given up substantial rights by signing it, and sign freely and voluntarily without an inducement. 


ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT In consideration of being allowed to participate on behalf of Legacy Cleveland Park Commission program and related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Cleveland Park Commission, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law. FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION) This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law. 

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