Participating School: Southwest Georgia Academy

Golden Triangle Resource Conservation & Development Council, Inc. ("Golden Triangle RC&D") provides access to its Heavy Equipment Simulator for educational and workforce development purposes. Participation is voluntary. Because simulator activities involve equipment operation training and related instruction, certain inherent risks may exist.

Please read this form carefully and complete all sections.

I understand that participation in the Golden Triangle RC&D Heavy Equipment Simulator program may involve risks including, but not limited to:

• Physical movement in and around simulator equipment
• Slips, trips, or falls
• Minor eye strain
• Motion Sickness

I acknowledge that Golden Triangle RC&D will take reasonable precautions to provide a safe learning environment.

I understand and voluntarily accept full responsibility for any risks of loss, property damage, or personal injury that may be sustained while participating in simulator activities, except in cases of gross negligence or willful misconduct.

In consideration of being permitted to participate in the Heavy Equipment Simulator program, I, on behalf of myself and/or my child, hereby release, waive, discharge, and covenant not to sue Golden Triangle RC&D, its board members, employees, volunteers, instructors, partners, sponsors, and affiliates from any and all liability, claims, demands, actions, or causes of action arising out of or related to participation in this program.

In the event of an emergency, I authorize Golden Triangle RC&D staff to secure emergency medical treatment for my child if I cannot be reached immediately. I understand that I am responsible for any medical expenses incurred.

If the participant is under 18 years of age, a parent or legal guardian must sign below.

I certify that I am the parent or legal guardian of the above-named student and that I have read and understand this waiver and release.