Japanese Speech Contest

Japanese Speech Contest
For Japanese Speech Contest Participants
Waiver of Liability for Participation in the
Japanese Speech Contest
Participant’s Name: ________________________________________________
Address: ____________________________________________________________
City/State/Zip: _______________________________________________________
Phone (day): ___________________
Phone (evening): ___________________
In the case of any bodily injury that the above participant, or other person(s) accompanying
the participant in any capacity, may sustain during the Speech Contest sponsored by the
Japanese American Association of Northern California, Consulate General of Japan in San
Francisco, and the Northern California Japanese Teachers’ Association Japan on Sunday,
October 23, 2016. I agree that neither the sponsors nor the property owner of the contest
location at the New People Cinema (1746 Post Street, San Francisco, CA 94115), will be
held legally responsible for the incident and that I relinquish my legal rights to bring a
lawsuit against them.
Signed by: _________________________________________________ Date: _______
Parent or Guardian of the participant
The above-signed parent or natural guardian or legal guardian does hereby represent that
he/she is, in fact, acting in such capacity and agrees to save and hold harmless and
indemnify the event co-sponsors from all liability, loss, cost, claim or damage whatsoever.
（日本語訳）
北加日米会・在サンフランシスコ総領事館広報文化センタ・北加日本語教師会ー殿
２０１６年１０月２３日、ニュー・ピープル・シネマにて開催される北加日米会、同総領事館
広報文化センター及び北加日本語教師会共催の日本語弁論大会会場において、上記の出場者又
はその同伴者に万一怪我その他の不祥事が起こった場合、共催者及び会場提供者のどちらにも
法律上の責任が無いことを承知しており、同件に関して全ての告訴する法的権利を任意放棄す
ることを誓います。

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