WAIVER OF LIABILITY
This certifies that I am donating, or have donated, my services, to the Palm Beach State College
Motion Picture & Television Production Technology Program without financial payment, for the production
of the film or video entitled ______which is being made by the students of the Palm Beach State College
Motion Picture & Television Production Technology Program.
By doing so, I release, hold harmless and indemnify Palm Beach State College, its officers,
employees and students from any and all liability for any injuries or damage occurring to my person or my
property, or any injuries or damage caused by me to other persons or property, during the period of my
association with this production.
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Print Name
Telephone #
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Street Address
Signature
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City
State
Zip Witness