THE NATIONAL SOCIETY OF THE COLONIAL DAMES OF AMERICA CONGRESSIONAL SEMINAR ESSAY CONTEST Please check the appropriate space in the box below, sign it and the General Release and Waiver of Liability if you are attending the Workshops. Return this sheet to Mrs. F. Thomas Siskron, III, 10420 Ellerbe Road, Shreveport, LA 71106 which is the address on the enclosed envelope. I have received your letter advising me that I am the winner of an NSCDA scholarship to the 2016 Washington Workshops Foundation Congressional Seminar to be held in Washington, D. C., June 18-24th. ________________I accept with pleasure ________________I am unable to accept the scholarship Name: _________________________________
GENERAL RELEASE AND WAIVER OF LIABILITY For and in consideration of attending the Washington Workshops Congressional Seminar, I ____________________________________________ (print name) hereby release THE NATIONAL SOCIETY OF THE COLONIAL DAMES OF AMERICA (NSCDA), AND ANY OF NSCDA’s affiliated entities and their officers, directors, members, agents, and employees from any and all liability, claims and causes of action arising out of, or in any way connected with my participation in the Washington Workshops Congressional Seminar held June 18 to June 24th, 2016 in Washington, DC (“The Workshops”). I personally assume all risks associated with traveling to Washington, DC and participating in the Workshops and further agree to indemnify the NSCDA and its affiliated entities and their officers, directors, members, agents and employees against all liability, claims and causes of action arising out of my participation and the Workshops. These risks include, but are not limited to, all forms of bodily injury, sickness and loss of or damage to my person or personal property. This General Release and Waiver of Liability Agreement shall bind my heirs, personal representatives, assigns and all members of my family, including any minors, I understand that this General Release of Liability is a contract and not a mere recital and that it shall remain in effect during the entire course of the Workshops. I have read and understand this General Release and Waiver of Liability Agreement in its entirety and acknowledge that by submitting this form, I am waiving certain legal rights, including the right to sue. Signed_______________________________ Date:________________________________ This form must be signed by the participant’s parent or legal guardian. Parent/Legal Guardian Signed:______________________________ Print Name:___________________________ Date:________________________________