Independent Study Physical Education- Indemnify Hold Harmless Agreement Date* Name* First Last Email* Name of Event or Activity* Location* Date*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Hours* INDEMNIFY AND HOLD HARMLESSAcknowledgement* I, named above, indemnify and hold harmless THE PATRICK SCHOOL, it employees, officials and agents from and against all of the following: Any claim, liability, loss, damage, cost, expense, including attorney's fees, awards or judgments arising by the reason of the death, bodily injury to persons, and/or property damage, including any of the same resulting from THE PATRICK SCHOOL (including its agents, employees or officials), alleged or actual negligent act or omission. However, it is agree that I, named above, shall not be obligated to indemnify and hold harmless THE PATRICK SCHOOL with respect to the sole negligence or will misconduct of THE PATRICK SCHOOL it agents, employees or officials. I, name above, at his/her own expense, cost and risk, shall defend any and all actions, suits, or other proceedings that my be brought or instituted against THE PATRICK SCHOOL, its officers, agents or employees, or any such claim, demand, or liability, and shall pay or satisfy any judgment that may be rendered against THE PATRICK SCHOOL, its officers, agents or employees in any action, suit, or other proceedings as a result thereof. Signature*