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Which Member

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Student Member

First Name*

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Are you OR your spouse OR one of your parents a citizen or former resident of Malaysia ? If your answer is Yes select Voting Members. If your answer is No select Associate Members.

If YES, who is the citizen or former resident of Malaysia?

Spouse

Parents

NIL

If YES, which Malaysian City and State ?

If NO, which country are you from ?

Waiver Form- Release and Covenant Not To Sue

The Undersigned, for himself/herself, personal representatives, assigns, heirs and next of kin, Herby RELEASE, WAIVES,DISCHARGES, AND CONVENANTS NOT TO SUE Malaysian Association of Southern California (MASC), its agents, volunteers or directors, for any injury, accident, illness, and death occurring during any and all the activities, events or excursions organized by MASC, including my injury, accident, illness or death resulting from the negligence of MASC, its agents, volunteers or directors.  The Undersigned agrees to indemnify MASC, its agents, volunteers or director from any and all legal action resulting from the Undersigned’s actions, including but not limited to, DUI, behavior or the actions including but not limited to DUI behavior of the Undersigned’s family members and participants who are invited by the Undersigned to MASC activities, events or excursions.  The Undersigned agrees t be responsible for his/her behavior or actions, behavior or actions of all family members and all participants who are invited by undersigned to MASC activities, events and excursions.  The Undersigned acknowledges that the activities/events/excursions addressed by this release is completely VOLUNTARY. Attendance is not mandatory by MASC.  This Waiver is valid from the date of signature till MASC receives a written revocation from the Undersigned.  The Undersigned’s signature below indicates that Undersigned has read and fully understands this entire document, and it shall be binding upon Undersigned, his or her representatives, assigns, heirs, and next of kin.

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Malaysian Association of Southern California

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