Request for FUSS’ Support of Event Form

Request for FUSS' Support of Event/Project/Workshop

1. Your proposal will be reviewed by the FUSS’ Team. 2. If applicable, prospective applicant(s) may be invited to give a 5-10 minutes presentation during FUSS’ meetings. 3. A FUSS Advisor/Representative may be assigned to the proposed event or project. 4. FUSS Advisor(s) shall be allowed to observe the program.

Step 1 of 3

Event / Project / Workshop Category*
Name of Event / Project / Workshop (e.g. Performance, STEM, Academic, Leadership, Business & Entrepreneurship, Public Speaking, Arts, Health, Music, Sports)*
(please provide short description in 100 words)
Date of Event / Project / Workshop*
Date Format: MM slash DD slash YYYY
Start Time*
: HH
MM
Duration of Event / Project / Workshop*
Event Site / Facilities*
Anticipated Number of Audience / Participants*
Number of Adult Supervisors (on-site adult supervision is required throughout the entire event/project/workshop. 1 adult per room / breakout room - 20 students (if K-7th grade), and 30 students (if 8th-12th grade)*
Goal of this Event / Project / Workshop*
Will Fees be charged? How much?*

Person in Charge of the Event / Project
Name of Applicant*
First Last
Applicant's Email*
Applicant's Phone*
School*
Grade Level / Title*
Name of Parent or Guardian (if the applicant is a minor)
First Last
Parent / Guardian Email
Parent / Guardian Phone

Information about Your Organization
Name of your Organization*
Location of Your Organization*
Website (if any)
Brief Description of your Organization*
Consent*
I, on behalf my group, consent to assume all risks and release FUSS of all liability.
I, ON BEHALF OF MY ENTIRE GROUP, HEREBY ASSUME ALL OF THE RISKS OF ORGANIZING/HOSTING/CONDUCTING OUR GROUP’S EVENT/WORKSHOPS/ACTIVITIES SUPPORTED/PROMOTED/SPONSORED BY FREMONT UNIFIED STUDENT STORE (FUSS), including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

In consideration of this proposal to have the support/promotion/sponsorship of Fremont Unified Student Store (FUSS), I hereby take action for myself, my entire group, our executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) I ON BEHALF OF MY GROUP, WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my/our death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me/us including my/our traveling to and from the activities and/or events, THE FOLLOWING ENTITIES OR PERSONS: Fremont Unified Student Store (FUSS), and/or their directors, officers, employees, volunteers, representatives, and agents, the activity or event holders, activity or event sponsors, activity or event volunteers;

(B) I AND MY GROUP INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims, whether caused by the negligence of release or otherwise.

I on behalf of my group acknowledge that Fremont Unified Student Store (FUSS) and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity.

The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I CERTIFY ON BEHALF OF MY GROUP THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON BEHALF OF MY GROUP OF OUR OWN FREE WILL.

Request for FUSS' Support of Event/Project/Workshop

Step 1 of 3

Person in Charge of the Event / Project

Information about Your Organization