I understand that using Campus Life's basketball courts, volleyball courts, house and fields at the Campus
Life house at 6401 Pine Lake Rd. is a privilege. In consideration of that privilege, I am signing the Release.
of Liability form on behalf of the group using the Campus Life properties.

I understand that by partaking in these activities at the Campus Life House there are certain risks, whether
such risks are known or unknown to me at this time. I further release Southeast Nebraska Youth for Christ/
':ampus Life, including its directors, volunteers, employees, and agents from any claims of physical injury or
Illness incurred during participation in these activities.

I hereby, for myself, my heirs, executor and administrators, waive and release any and all rights and claims
for damages that I may have against Southeast Nebraska Youth for Christ/Campus Life and its agents,
employees, representatives, successors, and assigns for any and all injuries suffered by our group that
arises out of the use of Campus Life's basketball courts, volleyball courts, house and fields.

I understand that the suggested donation for using the house is $150. Donation is requested before date of
usage. I also understand that I will leave the house clean when our group is done, or a fee of $60 will be


Almost done, where should we send the confirmation?

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