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  1. Each participant must complete and submit one form.

  2. If yes, Parent/Guardian must agree to waiver.
  3. WAIVER OF CLAIM:*


    I, Special Event participant, agree to Indemnify and to Hold the City of Midlothian, its agents, servants and employees, Harmless from any and all claims including all Third-Party Claims, together with all costs, expenses and legal fees the City may incur in defending such claims. I, expressly assume and waive the risk of any and all claims for which it might assert against the City, by or through itself or any third-party. Further, I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes/DVDs, motion pictures, recordings, and any other record of this event. I, will follow CDC COVID-19 guidelines and precautions in place on event date, including social distancing and wearing a face mask. 

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  5. This field is not part of the form submission.