Insurance & Risk Management	ENVIRONMENTAL HEALTH & SAFETY TEL NO: (818) 677-2079 FAX NO: (818) 677-5853 MAIL DROP: 8284
	Appendix I (Voluntary Participation)
	Liability Waiver & Release Form

In consideration for my voluntary participation in:

I, hereby irrevocably and personally release, hold harmless, and forever discharge the State of California, the Trustees of The California State University, California State University, Northridge, and each and every officer, agent, and employee of each of them (hereinafter collectively referred to as the "State") from all claims including death, causes of action, or liability of every kind which I may have in the future or that any person claiming through me may have in the future against the State by reason of any injury to person or property, or death, in connection with my participation in the activity described above. I have read this document and understand the terms used in it and their legal significance. This Release is freely and voluntarily given with the understanding that all rights to legal recourse against the State are knowingly given up in for allowing my participation in the activity described above.

THIS IS A RELEASE OF YOUR RIGHTS - PLEASE READ CAREFULLY BEFORE SIGNING

Participant Signature:_______________________________	Date: ______________
Print Name:	Phone:

Parent's or Guardian's Signature:______________________	Date: ______________
(IF PARTICIPANT IS A MINOR)
Print Name:	Phone: