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Utility Box Art Pilot Project (Phase Three) <br />City of Santa Ana <br />RELEASE of LIABILITY <br />Santa Ana Unified School District (SAUSD) / School Information (Please print) <br />Authorized SAUSD 1 School Representative Name: <br />Robert Angui.arna <br />SAUSD 1 School Address: <br />Davis Elementary School 1405 French St. <br />City: Santa Ana <br />Emergency Contact: Roxanna <br />Waiver and liability Release <br />State: CA Zip: 92701 <br />have read and understand the Santa Ana Unified School District Agreement and will adhere to <br />the rules and regulations set forth wherein and act in a respectful manner while representing the <br />City of Santa Ana. The SAUSD and/or participating School assumes the responsibility of <br />mental and physical fitness of the SAUSD and/or School staff, students, and volunteers to <br />participate in the assignment, and agrees to abide by all rules and requirements of the program. <br />also understand that failure to abide by the above may lead to the SAUSD's and/or School's <br />termination from the program. <br />understand that the SAUSD and/or School staff, students, and volunteers are not considered <br />employees of the City of Santa Ana for purposes of Workers' Compensation, but that the City <br />provides volunteer accident insurance in excess of any other medical insurance the SAUSD <br />and/or School staff, students, and volunteers may have. The SAUSD and/or School agree to <br />comply with the City's policy regarding any injuries any SAUSD and/or School staff, students, <br />and volunteers incur while under the City's supervision. <br />The SAUSD and/or School agree to hold harmless the City of Santa Ana, its officers, employees <br />and volunteers from and against any and all liability arising out of or in any way connected with <br />participations in the program. This release shall apply even though liability may arise out of <br />negligence or carelessness on the part of those discharged including their employees, agents <br />and volunteers. <br />This waiver and liability release shall apply to any SAUSD and/or School staff, students, <br />volunteers, executors or administrators. <br />I am of lawful age and legally competent to sign this agreement. I understand the terms and <br />have signed this document, on behalf of the SAUSD and/or School staff, students, and <br />volunteers, as my own free act. <br />