Release of Claims for Tractor Training Activity

This event in not affiliated with the Nebraska State FFA Organization or the Nebraska 4-H Youth Development Office.

This affirmation and release was executed the ____ day of ______at ______, State of Nebraska, County of ______, by ______(Parent or Guardian) in favor of the Board of Regents of the University of Nebraska (UNL). (Guardian refers to both legal parent and guardian in the following document.)

The student wishes to participate in the training activity provided by the Extension Service of UNL, commonly known as Tractor Safety Class. In consideration for the privilege of participating in this activity, the Guardian and Student agree to the following clauses.

  1. The guardian certifies that the student is physically capable of participating in the tractor safety training and that he/she will take responsibility for physical fitness and capability to perform under the normal conditions of the tractor training.
  1. The guardian understands it is not UNL’s function to serve as a guardian of the student’s safety or to teach common safety rules in the extracurricular setting.
  1. The guardian and student has hereby been made aware that participation in the tractor safety training has the following non-exhaustive list of particular risks: sprains, strains, abrasions, burns, fractures, concussions, dislocations, blisters and other potential risks.
  1. The guardian and student accept responsibility to ensure that any equipment needed to participate in the tractor safety training, and that the student actually uses, is safe and functioning properly. This will include long sleeve shirt, closed toe shoes and long pants.
  1. The guardian and student hereby personally assume all risks in connection with participation in the tractor safety training and hereby releases all students, instructors, agents, operators, and officials of UNL for any injury or damage which may befall the student while participating in the tractor safety training, and agrees to save and hold harmless UNL and any related persons from any claim by the student, or his/her family estate, heirs or assigns, arising out of the student’s participation in the tractor safety training.

Guardian certifies that he/she is legally competent to sign this affirmation and release for the student; that he/she understands that the terms contained herein are contractual and not mere recitals; and that he/she signed this document as his/her own free will act.

______Signature of Guardian ______date

______Student Name (please print)

□ Yes□ NoI give permission to use my child’s name/photograph in publications, news articles, videos, web sites, social media, or other electronic media pertaining to the Training.