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2001 East Avenue P Palmdale, CA 93550 661/267-5611 ADOPT-A-PLANE PROGRAM PARTICIPANT RELEASE OF LIABILITY Must be completed PRIOR to participating in any Adopt-a-Plane event. I understand that the Adopt-A-Plane program affords community groups and organizations the opportunity to participate in maintaining the static display aircraft at Joe Davies Heritage Airpark (“Airpark”), located at 2001 E. Avenue P, Palmdale, CA 93550. The below noted organization, of which I or my child is involved with, has agreed to sponsor the routine exterior cleaning, washing and waxing of one of the static display aircraft at the Airpark. I understand that it is the responsibility of myself and/or my child to abide by any and all program rules, safety guidelines and equipment standards posted by the Program. Sponsoring organization: Participant name: Age (if minor): Emergency phone I voluntarily agree to participate, or for my child to participate, in this program under the supervision of the sponsoring organization noted above. Further, I understand that as a volunteer, I am offering my services of my own free will without any expectation of compensation, benefits, or insurance of any kind. I hereby waive, release, and hold harmless from any liability or claims for damages for personal injury, including death, as well as from claims for property damage which may arise in connection with the above-named activity, against the supervisor, the City of Palmdale, U.S. Air Force Plant 42 and their respective elected and appointed officials, agents, and employees. This Waiver shall be binding upon my heirs and dependents as well as myself. As parent/guardian, I hereby consent to treatment of my minor child for any and all medical procedures deemed necessary, as a result of accident or injury. I further agree to pay any and all costs incurred as a result of said treatment. I hereby give permission to the City of Palmdale to use my (and my minor child’s) information and photographs as the City sees fit in the reporting of this event and in the marketing of future events of this nature. I understand the photographs belong to the City and I will not receive payment of any kind. Signature of Volunteer (or Parent or Guardian of minor) Date Address