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Return this form to:
International Student Services
South Puget Sound Community College
2011 Mottman Road SW
Olympia, WA 98512-6292
Fax: (360) 596-5708

RELEASE OF LIABILITY FORM

I, _____________________________________________, am below the age of 18 and I acknowledge that in the event that any harm should occur to myself, my property, or property or person of another, hereby release and agree to hold harmless South Puget Sound Community College District 24, and my host family from any and all liability, actions, debts, claims, demands of every kind and nature whatsoever, which may arise from or in connection with my attendance in this college.

______________________________________________ __________________
Signature of Student/Date

 

I, _____________________________________________ (Name of Father/Mother),

being the parent of _______________________________________ (Name of Student), have read this Release of Liability and we understand and do hereby agree to its terms and conditions.

______________________________________________ __________________
Signature of Father/ Date

______________________________________________ __________________
Signature of Mother/ Date

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| South Puget Sound Community College | 2011 Mottman Rd SW Olympia, WA 98512 | 360.596.5396 |