ࡱ> 130a Vbjbjzz 4P\P\V     ( m0<<<<<$S***<<'*<<*<TR.P@"=0mb<L0G"im****> :  COVENANT NOT TO SUE OFF-CAMPUS TRAINING AND PRACTICAL FIELD/HIGH RISK TRAINING (1) AUTHORITY: Title 10, U.S. Code 23-1. (2) PRINCIPAL PURPOSE(S): To release the U.S. Government, the host institution and the state in which said institution is located from liability for injury; death, or damages for JROTC cadets participating in voluntary off-campus training programs, practical field, and high risk training. (3) ROUTINE USES: Normal personnel actions. Disclosures of information may be provided to proper authorities in actions regarding law enforcement, legal actions as a result of injury or death, and investigations of accidents resulting from such voluntary off-campus training, practical field, and high-risk training. (4) MANDATORY OR VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION: Voluntary. Failure to complete form will disqualify JROTC cadet from participating in specific voluntary training exercises. I_______________________________, residing at _____________________________________ (Type or print full name) (Address) (City & State) do hereby agree that in consideration for being allowed to participate in JCLC, conducted by RCSD JROTC DAI____________, and Army supervised activity, and whereas I am doing (Name of JROTC Instructor Group) so entirely on my own initiative, risk, and responsibility; and being fully aware of the risk adhering to this type of training, I hereby RELEASE AND DISCHAGE FOREVER, the United States Army, the State of Mississippi and ________________________ and all of its officers, agents, and employees, acting (Name of School) officially or from any and all claims demands, actions or causes of action, on account of myself OR on account of any injury to me which may occur from any cause during said activity or continuances thereof, and I do further covenant and agree to hold the said Government of the United States, State of Mississippi, _______________________and all of its officers, agents, and employees, acting officially or (Name of School) otherwise, blameless for any and all damages which I may cause either intentionally or thru my negligence. ___________________________________ __________________________________ Typed/Printed Name of Parent or Guardian if Signature of Parent or Guardian if Participant is a Minor Participant is a Minor __________________________________ __________________________________ Relationship to Cadet Date __________________________________ Age/Period Covered __________________________________ Signature of Cadet PQRS`} 8 % ) 3 5 : B D E ߾l^hI~CJOJQJ^JaJ&h41Gha5>*CJOJQJ^JaJhaCJOJQJ^JaJhPCJOJQJ^JaJ hPhPCJOJQJ^JaJ hP5CJOJQJ\^JaJ&hPhP5CJOJQJ\^JaJhPhPOJQJ^JhPhP5OJQJ\^J hP5CJ(OJQJ\^JaJ(RS} E F   `a()1cgdP$a$gdP &d P gdP     #  CO_`aoz')3  GLbcӱ••‡•v hPhI~CJOJQJ^JaJhr]CJOJQJ^JaJhI~CJOJQJ^JaJh41GCJOJQJ^JaJ hPh41GCJOJQJ^JaJ hPhPCJOJQJ^JaJhPCJOJQJ^JaJhaCJOJQJ^JaJ hPhaCJOJQJ^JaJ.cd<VgdPgdPc<CUVм鍊hPhqCJaJhPhPCJaJhPCJaJhr]CJOJQJ^JaJ&hPhP5CJOJQJ\^JaJ hP5CJOJQJ\^JaJhPCJOJQJ^JaJ hPhPCJOJQJ^JaJ21h:pP/ =!"#$% s2&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontRiR  Table Normal4 l4a (k (No List bob PDefault 7$8$H$-B*CJOJQJ^J_HaJmH phsH tH PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] V  cV cV 8@0(  B S  ?\H\H\HllX ppX B*urn:schemas-microsoft-com:office:smarttagscountry-region9*urn:schemas-microsoft-com:office:smarttagsplace  X FH)2X 33  :B# EOao3   ; ; < C U X    :B# EOao3 X   6B. v:41GrI37qaUzr]I~PV X @V @UnknownG.[x Times New Roman5Symbol3. .Cx Arial7. [ @VerdanaA$BCambria Math"qhfsfs!x24Q Q 3QHP ?P2!xx CONVENANT NOT TO SUELTC (R) James R. McLeodJROTC Oh+'0  ( H T `lt|CONVENANT NOT TO SUELTC (R) James R. McLeodNormalJROTC2Microsoft Office Word@@4T.P@4T.P ՜.+,0 hp   RCSD JROTCQ  CONVENANT NOT TO SUE Title !"#$%&')*+,-./2Root Entry FW.P41TableWordDocument4SummaryInformation( DocumentSummaryInformation8(CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q