WAIVER OF LIABILITY AND RELEASE AGREEMENT I, ______________________ wish to participate in the Milledgeville-Baldwin’s Junior Miss Scholarship (name) Program (“MBJM”), a sponsored program of Milledgeville MainStreet/DDA. As a precondition to participating in Junior Miss, I have read the following Release Agreement (the “Agreement”) and agree to its terms. 1. Assumption of Risk. I understand that participating in the Junior Miss entails inherent risks of physical injury, including, but not limited to, the risks described in the Junior Miss Detail Form on the reverse side of this Release Agreement. I have been given the chance to ask questions concerning Junior Miss Detail Form, and all such questions have been answered to my satisfaction. Having read this form, I am fully aware of the risks and hazards associated with Junior Miss, and hereby elect to voluntarily participate in Junior Miss. I understand that Fitness routine is a part of the Junior Miss program, and that is an 8 minute aerobic routine. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury that may be sustained by me as a result of participating in Junior Miss. 2. Liability Release. In consideration for MBJM allowing me to participate in Junior Miss, I agree I will not sue MBJM, Milledgeville MainStreet/DDA or any party associated with a venue used for rehearsals and performances, and I release MBJM, Milledgeville MainStreet/DDA and any party associated with a venue used for rehearsals and performances from any and all liabilities, claims, demands, actions, causes of actions, costs and expenses of any nature whatsoever arising out of any loss, damage, or injury, including death, that may be sustained by me or to any property belonging to me, arising from Junior Miss or while upon the premises where Junior Miss activities are being conducted, excepting those claims arising from the gross negligence or willful misconduct of MBJM or Milledgeville MainStreet/DDA. 3. Indemnification. I agree to indemnify and hold harmless MBJM or Milledgeville MainStreet/DDA from and against any loss, liability, damage or costs, including court costs and attorneys’ fees, that MBJM or Milledgeville MainStreet/DDA may incur arising from my involvement in Junior Miss, excepting those claims arising from the gross negligence or willful misconduct of MBJM or Milledgeville MainStreet/DDA. 4. Warranty of Physical Fitness. I warrant that I am physically fit and in a condition that will allow me to participate fully in Junior Miss. I maintain medical insurance that covers me for accidents and illnesses while I am participating in this Activity. I understand MBJM or Milledgeville MainStreet/DDA has required a Health Certificate signed by my physician to attest to my physical fitness or ability to participate in Junior Miss, and MBJM or Milledgeville MainStreet/DDA is relying on this warranty of my physical condition. I assume full responsibility for payment of medical expenses not covered by my insurance incurred as a result of my participation in Junior Miss. 5. Emergency Medical Treatment. I grant MBJM or Milledgeville MainStreet/DDA permission to authorize emergency medical treatment as it deems appropriate, and agree that such action by MBJM or Milledgeville MainStreet/DDA shall be subject to the terms of this Agreement. I understand and agree that MBJM or Milledgeville MainStreet/DDA assumes no responsibility for any injury or damage that might arise out of or in connection with such authorized emergency medical treatment. It is my express intent that this Agreement shall bind the members of my family and spouse (if any), my estate, heirs, administrators, assigns, and personal representatives. I agree that this Agreement and any claim arising from my participation in Junior Miss shall be construed in accordance with the laws of the state of Georgia, without regard to its conflict of laws provision. The courts in Baldwin County shall be the forum for any lawsuits arising from Junior Miss or incident to this Agreement. The terms of this Agreement shall be severable, such that if a court of competent jurisdiction holds any term to be illegal or unenforceable, the validity of the remaining portions of shall not be affected thereby. In signing this Agreement, I acknowledge that I have read both sides of this Release Agreement form, understand it, and agree to be bound by its terms. I further acknowledge that I sign this Release Agreement voluntarily and I am under eighteen years of age which also requires consent from a parent or guardian. Name of Participant (printed) Signature Name of Parent/Guardian (printed) Signature THIS IS A RELEASE OF LEGAL RIGHTS. READ AND UNDERSTAND BOTH SIDES BEFORE SIGNING. ACTIVITY DETAIL FORM The Junior Miss program requires participants to compete in & rehearse for the Fitness category. This routine requires participants to engage themselves in an 8-minute high-enegry choreographed aerobic routine. The Fitness routines movements include, but are not limited to running, lunges, sit-ups, push-ups, jumping jacks, kicks, jumps and crunches. In the Fitness category of competition judges evaluate a contestant's overall conditioning during a choreographed aerobic routine while looking for freshness, vigor, spirit and good health, and consider the following criteria: . Agility: quickness & lightness of movement, ability to move easily & quickly, nimbleness, flexibility . Coordination: ability to perform physically with a sense of timing and ease . Stamina: endurance, staying power . Carriage & Posture: manner of carrying the head & body, the position of the body & limbs as a whole . Attitude: naturalness, enjoyment of what she is doing, rapport with the audience By participating in the above activities you may be exposed to several inherent risks, including but not limited to those listed below: . Lower leg problems . Shin Splints . Fractures . Lower Back Problems . Shoulder Problems . Tendonitis . Muscle Pulls . Nausea . Dizziness . Dehydration . Can aggravate current injuries or disorders . Knee injuries . Asthma . Diabetes . Seizures . Cardiopulmonary Disease . Etc. We request you conduct your participation with the safety of yourself and others in mind. PLEASE READ AND SIGN THE RELEASE AGREEMENT ON THE REVERSE SIDE OF THIS FORM.