LIABILITY WAIVER

I, am participating /Guardian of a Participant in a course held by Block Home Defense and Security. By signing and dating this waiver I acknowledge that I will not hold Block Home Defense and Security, their instructors, officers, staff or associates accountable or liable for loss or damage of personal property. I also will not hold Block Home Defense and Security, their instructors, officers, staff or associates accountable or liable for any personal injury sustained while participating in this training. I will not hold Block Home Defense and Security, their instructors, officers, staff or associates accountable or liable in the future for any loss or damage to my personal property or personal injury to myself or others.

Any product purchased from Block Home Defense and Security, their instructors, officers, staff or associates that might fail or become damaged or cause damage the product manufacturer may only be held responsible. Please retain all manufacturer information, guarantees and warranties.

Notice: No individual eleven (11) years of age or younger may attend courses provided by or through Block Home Defense and Security. Print Full Name of Attendee: Address of Attendee: Attendee Phone #: Attendee Age:

Course Name:

Course Date:

I, the Attendee have read and agree to the terms set forth within this waiver.

Signature of Attendee

Date

I, the Guardian of the Attendee, who is under the age of eighteen (18), have read and agree to the terms set forth within this waiver.

Signature of Guardian

Date

LLW2012