Release and Indemnification. In consideration of the acceptance of participant’s application to participate in the PTSA Graduation Party Activity, we hereby waive, release and forever discharge the Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistants, and others associated with this activity, from any and all damages, risks, hazards, and person injury incidental, which may hereafter result from or which may accrue as a result of participation in said activity. This release is intended to release and discharge in advance those named above from all liability based on negligence, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risks, known or unknown. Furthermore, we voluntarily, clearly and unequivocally agree to assume those risks with the realization that we have the alternative of choosing not to participate in this activity. I understand that if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may be made to a parent/guardian anytime during said activity. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We have read and understand the foregoing liability release, indemnification and consent agreement and agree to all of the terms and conditions set forth herein. DATED THIS day of 2022 Name of Parent/Guardian (please print) Signature of Participant Signature of Parent/Guardian I understand that if my student leaves the Grad Night event early, they will not be allowed in again under any circumstances.
Appears in 1 contract
Samples: hhs.canyonsdistrict.org
Release and Indemnification. In consideration of The Certified Resident hereby releases the acceptance of participant’s application to participate in the PTSA Graduation Party ActivityPool Committee, we hereby waiveAssociation, release Board, Association Business Management Partner, Pool Maintenance Management Partner and forever discharge the Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, PTSA board their respective members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizersaffiliates, officers, assistantsdirectors, shareholders, agents, employees, successors and others associated with this activityassigns (collectively the “Released Parties”) and agrees to indemnify, defend and hold the Released Parties harmless from any and all liability, responsibility, injury, claims, damages, risksor causes of action of any nature whatsoever, hazardswhether in contract, tort, or by statute, Certified Resident or Certified Resident’s Non-Certified Family Members or Invitees have, may have or might sustain, arising out of, relating to, or connected with their use of the Swimming Pool. THE OBLIGATIONS OF CERTIFIED RESIDENT UNDER THIS INDEMNIFICATION SHALL APPLY EVEN IF SUCH LIABILITIES ARE CAUSED IN WHOLE OR IN PART BY THE SOLE OR CONCURRENT NEGLIGENCE OF THE RELEASED PARTIES AND WHETHER OR NOT SUCH SOLE OR CONCURRENT NEGLIGENCE OF THE RELEASED PARTIES WAS ACTIVE OR PASSIVE OR BY ANY MATTER OR THING IN WHICH LIABILITY MIGHT BE IMPOSED. THE CERTIFIED RESIDENT UNDERSTANDS THAT THE USE OF THE POOL CARD ALLOWS THE CERTIFIED RESIDENT TO HAVE USE OF THE SWIMMING POOL WHEN THERE IS NO LIFEGUARD PRESENT AT THE HOURS OF THE DAY SPECIFIED BY THE ASHFORD COMMUNITY POOL CARD ACCESS PROGRAM RULES AND POLICY RIGHT OF THE BOARD OR ASSOCIATION TO REMOVE POOL CARD PRIVILEGES. The Certified Resident understands that the privilege granted to the Certified Resident, as stated herein, can be removed, by the Committee, Board, or Association, for violation of the Rules as stated herein. Form may be returned to: Ashford Community c/o Graham Management 0000 Xxxxxxxx Xx. Xxxxx 000 Houston, Tx 77042 Or faxed to 000-000-0000 Or sent via email to xxxxxx@xxxxxxxxxxxxxxxxxxxxxxx.xxx Office hours are Monday through Thursday, 9am to 5pm, Friday 9 am to 12pm. Owner/Resident Initials Card No. Page 2 of 3 Ashford Community Association Pool Card Form The access card will open the pool and tennis court. All maintenance fees, fines, and person injury incidentalinterest must be paid in full to obtain an access card. The 1st pool card is $10, which may hereafter result from replacement is $20. Only check or which may accrue as a result of participation in said activitymoney order is accepted made out to “Ashford Community”. This release is intended Please return form and payment to release and discharge in advance those named above from all liability based on negligenceXxxxxx Management at 0000 Xxxxxxxx Xx, recklessnessXxxxx 000, or carelessness but not for intentional torts or intentionally causing injuryXxxxxxx, XX 00000. We hereby assume those risks, known or unknown. Furthermore, we voluntarily, clearly and unequivocally agree to assume those risks with the realization that we have the alternative of choosing not to participate in this activity. I understand that if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may be made to a parent/guardian anytime during said activity. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activityIF YOU ARE RENTING PLEASE PROVIDE A COPY OF YOUR LEASE AGREEMENT I, the vendorsCertified Resident, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We acknowledge that I have read and understand the foregoing liability release, indemnification terms of the Agreement and consent agreement and that I agree to all the terms of the terms and conditions set forth hereinAgreement. DATED Owner/Resident Name: Property Address: City/State/Zip: Email Address: Home Phone # Cell Phone # Signature: Date: Parent or Legal Guardian of: Name(s) & Ages PLEASE DO NOT WRITE BELOW THIS day of 2022 Name of Parent/Guardian (please print) Signature of Participant Signature of Parent/Guardian I understand that if my student leaves the Grad Night event early, they will not be allowed LINE - FOR OFFICE USE ONLY Pool Card(s)# Check or Money Order # Acct paid in again under any circumstances.full: Yes No Amount: Date: Rcvd:
Appears in 1 contract
Samples: Ashford Community Pool
Release and Indemnification. In consideration of the acceptance of participant’s application to participate in the PTSA Graduation Party Activity, we I hereby waive, release and forever discharge the Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistants, and others associated with this activity, from waive any and all damagesclaims that I may have against the Boy Scouts of America PA Dutch Council, risksBSA and their employees, hazardsagents, and person injury incidentalrepresentatives, which may hereafter result or volunteers arising from or which may accrue as a result of my child’s participation in said BMX Pump Bike Riding. I FULLY INDEMNIFY AND HOLD HARMLESS BOY SCOUTS OF AMERICA PA DUTCH COUNCIL, BSA AND THEIR EMPLOYEES, AGENTS, REPRESENTITIVES, AND VOLUNTEERS FROM ANY AND ALL CLAIMS ARISING FROM MY CHILD’S PARTICIPATION IN BMX Pump Bike Riding. THIS INDEMNIFICATION EXPRESSLY INCLUDES ANY CLAIMS ARISING OUT OF THE BOY SCOUTS OF AMERICA PA DUTCH COUNCIL, BSA’S OWN NEGLIGENCE OR FAULT THAT OF THEIR EMPLOYEES, AGENTS, REPRESENTATIVES, OR VOLUNTEERS. I AGREE THAT THE INDEMNIFICATION INCLUDES THE AMOUNT OF THE CLAIMS, THE EXPENSES OF DEFENDING AGAINST THE CLAIMS, COURT COSTS, AND ATTORNEY’S FEES. I certify that this participant can meet health and physical fitness requirement of the trip or activity. This release is intended to release and discharge in advance those named above from all liability based on negligenceIn case of emergency, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risks, known or unknown. Furthermore, we voluntarily, clearly and unequivocally agree to assume those risks with the realization that we have the alternative of choosing not to participate in this activity. I understand that if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may every effort will be made to a parent/guardian anytime during said activitycontact me. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, In the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We have read and understand the foregoing liability release, indemnification and consent agreement and agree to all of the terms and conditions set forth herein. DATED THIS day of 2022 Name of Parent/Guardian (please print) Signature of Participant Signature of Parent/Guardian event I understand that if my student leaves the Grad Night event early, they will cannot be allowed reached, I hereby give permission to the physician selected by the adult leader in again under any circumstances.charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injection of medication for my child. (THIS FORM MUST BE SIGNED BY BOTH PARENTS / GUARDIANS or ONE PARENT WITH LEGAL CUSTODY OF NAMED CHILD IN EVENT OF SEPARATION/DIVORCE) Parent / Guardian Signature Parent / Guardian Signature Print Name Print Name Home Phone / Cell Phone Home Phone / Cell Phone Date Date
Appears in 1 contract
Samples: padutchbsa.org
Release and Indemnification. In consideration of the acceptance of participant’s application to participate in the PTSA Graduation Party Activity, we Participant hereby waive, release fully and forever discharge the Dimple Dell Recreation Centerreleases, Salt Lake Countydischarges, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistantsholds harmless, and others associated with this activity, agrees to indemnify U.S. Figure Skating from and against any and all liabilities, claims, demands, lawsuits, damages, risksand judgments, hazards, and person injury incidental, which may hereafter result from present or which may accrue as a result of participation in said activity. This release is intended to release and discharge in advance those named above from all liability based on negligence, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risksfuture, known or unknown. Furthermore, we voluntarilyvalid or invalid, clearly direct or consequential, together with reasonable costs and unequivocally agree attorneys’ fees, which result directly or indirectly from damages, losses, injuries or death to assume those risks Participant, Participant’s property, other persons or property incurred during or in connection with any activities associated with or being a part of the Events and Activities and the conduct and management thereof, including any participation, travel or medical treatment, hospitalization or other care rendered in connection with the realization that we have Events and Activities, whether such loss, damage, injury or death results from the alternative negligence of choosing not to participate in this activityU.S. Figure Skating or from some other cause. I understand that HAVE READ THIS ASSUMPTION OF RISK, WAIVER AND RELEASE, AND INDEMNIFICATION AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I AND THE MINOR HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE. I INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE REMAINING PROVISIONS SHALL CONTINUE IN FULL FORCE AND EFFECT. Signature of Parent/Guardian (if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may be made to a parent/guardian anytime during said activity. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We have read and understand the foregoing liability release, indemnification and consent agreement and agree to all of the terms and conditions set forth herein. DATED THIS day of 2022 Participant is under 18) Date Printed Name of Parent/Guardian (please print) Signature of Participant Participant/Skater Date Printed Name of Participant/Skater June 1, 2020 AUTHORIZATION AND CONSENT FOR EMERGENCY MEDICAL CARE 2020-21 Competition Season The undersigned provides this Authorization and Consent for Emergency Medical Care in consideration of the opportunity to participate in U.S. Figure Skating sanctioned events and activities during the 2020-21 U.S. Figure Skating Competition Season (“Events and Activities”). In the event of illness, injury or medical or other emergency circumstances while participating in any of the Events and Activities, and if I am disabled or incompetent to make appropriate decisions concerning treatment thereof (and in the case that participant is a minor and minor’s parent or legal guardian cannot be timely contacted to participate in the making of necessary decisions), I, the participant, or if participant is a minor, I as the parent/guardian of said participant, give my consent to U.S. Figure Skating, its agents, officials, employees, volunteers, clubs, instructors, and trainers, , and the agents, officials, employees, volunteers, instructors, and trainers at the facility where any of the Events and Activities are taking place, to obtain emergency medical care from any licensed physician, hospital or clinic, including transportation and emergency medical service for myself/ourselves and/or said participant for any injury or illness that could arise from participation in the Events and Activities. In addition, in conjunction with participation in the Events and Activities, I acknowledge the provisions of and, if circumstances warrant, consent to the implementation of the procedures and precautions contained in U.S. Figure Skating’s Blood-Borne Pathogen Procedures. I further authorize and consent to the release of any pertinent medical information and records regarding my treatment, diagnosis and/or examination to the U.S. Figure Skating Sports Medicine Committee and the Medical Committee Staff of the Events and Activities in which I am participating. Signature of Parent/Guardian (if Participant is under 18) Date Print Name of Parent/Guardian Signature of Participant/Skater Date Print Name of Participant/Skater June 1, 2020 NAME AND LIKENESS RELEASE AND CONSENT AGREEMENT By registering for the 2020-21 Competition Season of U.S. Figure Skating, and for good and valuable consideration, I release and grant to U.S. Figure Skating, including its subsidiary and affiliated entities, and U.S. Figure Skating authorized local organizing committees, clubs, and interclub associations (collective, for purposes of this Release and Consent Agreement, “U.S. Figure Skating”), the right to use my name, likeness, image, photograph, voice, video, athletic performance, biographical information and any other indicia of identity, in any format, medium, technology and platforms whatsoever, from any U.S. Figure Skating event or activity in which I participate during the 2020-21 competition season, including any international competitions that I participate in as an assigned member of Team USA (collectively, my "Identifications"), and to distribute, broadcast and exhibit (and to permit U.S. Figure Skating’s broadcast partner, NBC Universal Media, to distribute, broadcast and exhibit) my Identifications, without charge, restriction or liability, in any media now known or hereafter devised (including, but not limited to, television, internet, web casting, and video streaming) or in various publications (including, but not limited to, SKATING Magazine, the U.S. Figure Skating directory or media guide and marketing materials) into perpetuity, unless otherwise specified and agreed upon. I understand that if my student leaves the Grad Night event early, they I will not receive any compensation for any such use of my Identifications. It is also agreed, however, that without my written permission: (a) at no time can my Identifications be allowed used by U.S. Figure Skating for any commercial purpose (e.g., use in again connection with the promotion of any commercial entity and/or its relationship with U.S. Figure Skating or with me, including one that expresses or implies an endorsement of any company or its products or services) and (b) at no time may U.S. Figure Skating release or authorize the use of my Identifications to an unrelated third party for the purpose of my endorsement of any commercial property, product or service, without my written permission. I HAVE READ THIS RELEASE AND CONSENT AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE. Signature of Parent/Guardian (if Participant is under any circumstances.18) Date Printed Name of Parent/Guardian Signature of Participant/Skater Date Printed Name of Participant/Skater
Appears in 1 contract
Samples: And Indemnification Agreement
Release and Indemnification. In consideration of the acceptance of participant’s application to participate in the PTSA Graduation Party Activity, we Participant hereby waive, release fully and forever discharge the Dimple Dell Recreation Centerreleases, Salt Lake Countydischarges, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistantsholds harmless, and others associated with this activity, agrees to indemnify Learn to Skate USA from and against any and all liabilities, claims, demands, lawsuits, damages, risksand judgments, hazards, and person injury incidental, which may hereafter result from present or which may accrue as a result of participation in said activity. This release is intended to release and discharge in advance those named above from all liability based on negligence, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risksfuture, known or unknown. Furthermore, we voluntarilyvalid or invalid, clearly direct or consequential, together with reasonable costs and unequivocally agree attorneys’ fees, which result directly or indirectly from damages, losses, injuries or death to assume those risks Participant, Participant’s property, other persons or property incurred during or in connection with any activities associated with or being a part of the Events and Activities and the conduct and management thereof, including any participation, travel or medical treatment, hospitalization or other care rendered in connection with the realization that we have Events and Activities, whether such loss, damage, injury or death results from the alternative negligence of choosing not Learn to participate in this activitySkate USA or from some other cause. I understand that HAVE READ THIS ASSUMPTION OF RISK, WAIVER AND RELEASE, AND INDEMNIFICATION AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I AND THE MINOR HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE. I INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE REMAINING PROVISIONS SHALL CONTINUE IN FULL FORCE AND EFFECT. Signature of Parent/Guardian (if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may be made to a parent/guardian anytime during said activity. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We have read and understand the foregoing liability release, indemnification and consent agreement and agree to all of the terms and conditions set forth herein. DATED THIS day of 2022 Participant is under 18) Date Printed Name of Parent/Guardian (please print) Signature of Participant Signature Participant/Skater Date Printed Name of ParentParticipant/Guardian I understand that if my student leaves the Grad Night event early, they will not be allowed in again under any circumstances.Skater
Appears in 1 contract
Samples: And Indemnification Agreement
Release and Indemnification. I hereby release and waive any and all claims that I may have against Boy Scouts of America Pacific Skyline Council, BSA and their employees, agents, representatives, or volunteers arising from my child’s participation in BSA’s TROOP 87 activities > I AGREE TO FULLY INDEMNIFY AND HOLD HARMLESS BOY SCOUTS OF AMERICA PACIFIC SKYLINE COUNCIL, BSA, AND THEIR EMPLOYEES, AGENTS, REPRESENTATIVES, AND VOLUNTEERS FROM ANY AND ALL CLAIMS ARISING FROM MY CHILD’S PARTICIPATION IN BSA’s TROOP 87 ACTIVITIES. THIS INDEMNIFICATION EXPRESSLY INCLUDES ANY CLAIMS ARISING OUT OF THE BOY SCOUTS OF AMERICA PACIFIC SKYLINE COUNCIL, BSA’S OWN NEGLIGENCE OR FAULT OR THAT OF THEIR EMPLOYEES, AGENTS, REPRESENTATIVES, OR VOLUNTEERS. I AGREE THAT THE INDEMNIFICATION INCLUDES THE AMOUNT OF THE CLAIMS, THE EXPENSES OF DEFENDING AGAINST THE CLAIMS, COURT COSTS AND ATTORNEY’S FEES. In case of emergency, I understand that every effort will be made to contact me. In the event that I cannot be reached, I hereby give my permission to the physician selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery or injections of medication for my child. This form must have a parent/guardian signature. Parent Signature Telephone Number Print Parents Name Date Pacific Skyline Council Boy Scouts of America PARENTAL INFORMED CONSENT AGREEMENT FOR CLIMBING/RAPPELLING ACTIVITIES I understand that participation in climbing/rappelling activities offered through the Pacific Skyline Council, BSA, for the period covering March 2007 – March 2008, involves a certain degree of risk that could result in injury or death. In consideration of the acceptance benefits to be derived and after carefully considering the risk involved, and in view of participant’s application the fact that the Boy Scouts of America is an organization in which membership is voluntary, and having full confidence that precautions will be taken to ensure the safety and well-being of my (son/daughter), I have given my consent to participate in the PTSA Graduation Party Activityclimbing/rappelling activities. In case of emergency, we hereby waive, release and forever discharge the Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistants, and others associated with this activity, from any and all damages, risks, hazards, and person injury incidental, which may hereafter result from or which may accrue as a result of participation in said activity. This release is intended to release and discharge in advance those named above from all liability based on negligence, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risks, known or unknown. Furthermore, we voluntarily, clearly and unequivocally agree to assume those risks with the realization that we have the alternative of choosing not to participate in this activity. I understand that if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may every effort will be made to contact me. In the event that I cannot be reached, I hereby give my permission to the physician selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery or injections of medication for my child. This form must have a parent/guardian anytime during said activitysignature. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We have read and understand the foregoing liability release, indemnification and consent agreement and agree to all of the terms and conditions set forth herein. DATED THIS day of 2022 Name of Parent/Guardian (please print) Parent Signature of Participant Signature of Parent/Guardian I understand that if my student leaves the Grad Night event early, they will not be allowed in again under any circumstances.Telephone Number
Appears in 1 contract
Samples: www.troop87.us
Release and Indemnification. In consideration of the acceptance of participant’s application to participate in the PTSA Graduation Party Activity, we I hereby waive, release and forever discharge the Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistants, and others associated with this activity, from waive any and all damagesclaims that I may have against the Boy Scouts of America, risksPA Dutch Council, hazardsBSA and their employees, and person injury incidentalagents, which may hereafter result representatives, or volunteers arising from or which may accrue as a result of my child’s participation in said BMX Pump Bike Riding and/or Pedal Cart Riding. I FULLY INDEMNIFY AND HOLD HARMLESS BOY SCOUTS OF AMERICA, PA DUTCH COUNCIL, BSA AND THEIR EMPLOYEES, AGENTS, REPRESENTITIVES, AND VOLUNTEERS FROM ANY AND ALL CLAIMS ARISING FROM MY/MY CHILD’S PARTICIPATION IN BMX Pump Bike Riding and/or Pedal Cart Riding. THIS INDEMNIFICATION EXPRESSLY INCLUDES ANY CLAIMS ARISING OUT OF THE BOY SCOUTS OF AMERICA, PA DUTCH COUNCIL, BSA’S OWN NEGLIGENCE OR FAULT OF THEIR EMPLOYEES, AGENTS, REPRESENTATIVES, OR VOLUNTEERS. I AGREE THAT THE INDEMNIFICATION INCLUDES THE AMOUNT OF THE CLAIMS, THE EXPENSES OF DEFENDING AGAINST THE CLAIMS, COURT COSTS, AND ATTORNEY’S FEES. I certify that this participant can meet health and physical fitness requirement of the trip or activity. This release is intended to release and discharge in advance those named above from all liability based on negligenceIn case of emergency, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risks, known or unknown. Furthermore, we voluntarily, clearly and unequivocally agree to assume those risks with the realization that we have the alternative of choosing not to participate in this activity. I understand that if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may every effort will be made to a parent/guardian anytime during said activitycontact me. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, In the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We have read and understand the foregoing liability release, indemnification and consent agreement and agree to all of the terms and conditions set forth herein. DATED THIS day of 2022 Name of Parent/Guardian (please print) Signature of Participant Signature of Parent/Guardian event I understand that if my student leaves the Grad Night event early, they will cannot be allowed reached, I hereby give permission to the physician selected by the adult leader in again under any circumstances.charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injection of medication for my child. (THIS FORM MUST BE SIGNED BY BOTH PARENTS / GUARDIANS or ONE PARENT WITH LEGAL CUSTODY OF NAMED CHILD IN EVENT OF SEPARATION/DIVORCE) Parent / Guardian Signature Parent / Guardian Signature Print Name Print Name Home Phone / Cell Phone Home Phone / Cell Phone Date Date
Appears in 1 contract
Samples: padutchbsa.org
Release and Indemnification. In consideration I for myself and my child, and on behalf of our heirs, executors, administrators, personal representatives and assigns, HEREBY RELEASE, INDEMNIFY AND HOLD HARMLESS THE RELEASEES, WHICH INCLUDES THEIR OWNERS, DIRECTORS, OFFICERS, EMPLOYEES, INDEPENDENT CONTRACTORS, AGENTS, SPONSORS, ADVERTISERS, AND ANY OTHER LESSEES OF THE PREMISES, WITH RESPECT TO ANY AND ALL INJURIES, DISABILITY, DEATH OR DAMAGE TO ANY PERSON OR PROPERTY, AND INCLUDING ATTORNEY’S FEES, COURT COSTS AND INVESTIGATIVE COSTS, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. Participant’s Name Participant’s Age Signature of Participant if over 18 years old Signature of Parent/Guardian if Participant is under 18 years old Parent/Guardian’s name if Participant is under 18 years old Name of Emergency Contact and Telephone # Date I the acceptance of participant’s application undersigned, hereby expressly and affirmatively state that I wish to participate in the PTSA Graduation Party Activityinstructional speed, we hereby waiveagility and strength training programs, release boot camp programs, sports simulated training programs and forever discharge any related events and activities and any related events and activities (collectively referred to as the Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistants, and others associated with this activity, from any and all damages, risks, hazards, and person injury incidental, which may hereafter result from or which may accrue as a result of “Program”). I realize that my participation in this activity includes but are not limited to broken bones, concussion, heart attack, stroke, serious illness, serious permanent injury, paralysis and even death, as well as damages to property, serious permanent injury, paralysis and even death as well as damages to property. However, knowing, understanding and appreciating said activity. This release is intended to release inherent risks and discharge other possible injuries not mentioned above, I hereby expressly assume responsibility for such delineated risks and other possible risks which could occur by reason of my participation in advance those named above from all liability based on negligence, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risks, known or unknown. Furthermore, we voluntarily, clearly and unequivocally agree to assume those risks with the realization that we have the alternative of choosing not to participate in this activityProgram. I understand affirm that if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may be made to a parent/guardian anytime during said activity. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We I have read and understand the foregoing liability release, indemnification and consent agreement and agree to all terms of the terms and conditions set forth hereinthis Agreement. DATED THIS day of 2022 Participant’s Name of Parent/Guardian (please print) Signature of Participant if over 18 years old Signature of Parent/Guardian I understand that if my student leaves the Grad Night event early, they will not be allowed in again Participant is under any circumstances.18 years old
Appears in 1 contract
Samples: Liability Waiver
Release and Indemnification. In consideration I for myself and my child, and on behalf of our heirs, executers, administrators, personal representatives and assigns, HEREBY RELEASE, INDEMNIFY AND HOLD HARMLESS THE RELEASEES, WHICH INCLUDES THEIR OWNERS, DIRECTORS, OFFICERS, EMPLOYEES, INDEPENDENT CONTRACTORS, AGENTS, SPONSORS, ADVERTISERS, AND ANY OTHER LESSEES OF THE PREMISES, WITH RESPECT TO ANY AND ALL INJURIES, DISABILITY, DEATH OR DAMAGE TO ANY PERSON OR PROPERTY, AND INCLUDING ATTORENY’S FEES, COURT COSTS AND INVESTIGATIVE COSTS, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. Participant’s Name Participant’s Age Signature of Participant if over 18 years old Signature of Participant/Guardian if participant is under 18 years old Parent/ Guardian’s name if Participant is under 18 years old Name of Emergency Contact and Telephone # Date I the acceptance of participant’s application undersigned, hereby expressly and affirmatively state that I wish to use and participate in the PTSA Graduation Party Activityfacility known as 0000 Xxxxxxx Xxxx, we hereby waiveMassapequa, release NY 11758 (referred to as the “Facility”) with my sports team and/or club with team practices and forever discharge the Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, PTSA board members, parents who help sponsor or supervise this activity, the vendors, Hillcrest High School and Canyons School District and their sponsors, organizers, officers, assistantstraining, and others associated with any other related activities (collectively “stated purposes”). I realize that my participation in this activityactivity includes but are not limited to broken bones, from any concussion, heart attack, stroke, serious illness, serious permanent injury, paralysis, and all damageseven death, as well as damages to property. However, knowing, understanding and appreciating said inherent risks and other possible injuries not mentioned above, I hereby expressly assume responsibility for such delineated risks and other possible risks, hazards, which could occur by reason of my use and person injury incidental, which may hereafter result from or which may accrue as a result of participation in said activity. This release is intended to release the Facility and discharge in advance those named above from all liability based on negligencesuch, recklessness, or carelessness but not for intentional torts or intentionally causing injury. We hereby assume those risks, known or unknown. Furthermore, we voluntarily, clearly and unequivocally agree to assume those risks with the realization that we have the alternative of choosing not to participate in this activitystated purposes. I understand affirm that if the participant violates any terms of this release or any rules of the Recreation Center, a phone call may be made to a parent/guardian anytime during said activity. We agree to absolve, hold harmless and indemnify Dimple Dell Recreation Center, Salt Lake County, HHS PTSA, and HHS PTSA Board members, interested parents who help supervise or sponsor this activity, the vendors, Hillcrest High School, Canyons School District, and their sponsors, organizers, officers, assistants, and others associated with this activity. READ BEFORE SIGNING We I have read and understand understood the foregoing liability release, indemnification and consent agreement and agree to all terms of the terms and conditions set forth hereinAgreement. DATED THIS day of 2022 Participant’s Name of Parent/Guardian (please print) Signature of Participant if over 18 years old Signature of Parent/Guardian I understand that if my student leaves the Grad Night event early, they will not be allowed in again Participant is under any circumstances.18 years old Parent/ Guardian’s name if Participant is under 18 years old
Appears in 1 contract
