• Circle C Ranch Daycamps Registration and Liability Release Form

  • Student Information

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  • Parent/Guardian Information

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  • Emergency Information

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  • Informed Consent and Acknowledgement

  • I, the undersigned, do hereby release, forever discharge and agree to hold harmless Circle C Ranch, its Board members, directors, and volunteers, from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in Day Camps. I, the parent or legal guardian of this Participant hereby grant my permission for the Participant to participate in activities associated with the Day Camp experience.

    Furthermore, I, on behalf of my minor Participant, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. In case of injury to said child, I hereby waive all claims against Circle C Ranch including all leaders and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

    The undersigned further hereby agrees to hold harmless and indemnify Circle C Ranch for any liability sustained as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto.

  • Medical Release and Authorization

  • As Parent and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
    Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named student. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
    Permission is also granted to Circle C Ranch and its affiliates, Directors, Activity coordinators, counselors, and medical volunteers to provide the needed emergency treatment prior to the child’s admission to the medical facility. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

  • Transportation Release and AuthorizationHeading

  • The undersigned does also hereby give permission for my child/youth to ride in any vehicle driven by an approved and licensed adult chaperone while attending and participating in activities sponsored by Circle C Ranch. My child/youth and I understand that seat belts must be worn at all times during transportation.

  • Photo Release and Authorization:

  • I agree that Circle C Ranch may photograph and/or record my child/dependent during daycamp-related activities. I grant the following rights to Circle C Ranch: permission to use and re-use, publish and re-publish, and modify or alter the Images taken during an event. Use of the images or footage for editorial, commercial, trade, advertising and any other purposes may be done in any medium now existing or subsequently developed, on Circle C Ranch website and on the Internet.

  • Confirmation

  • I represent and acknowledge that I have read and understand this agreement and release form and warrant that all statements made herein are true to the best of my knowledge.

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  • WAIVER OF LIABILITY, RELEASE AND HOLD HARMLESS

  • I, the undersigned, hereby release, covenant not to sue, discharge, and hold harmless the Circle C Ranch, its officers, employees, agents, volunteers and representatives, from any and all Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto for any injuries or damages sustained or incurred while attending or participating in any event or activity at or on Circle C Ranch.  I  understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Circle C Ranch, its officers, employees, agents, volunteers and representatives.

    I also acknowledge and accept the risks involved in ANY AND ALL activities or events on or at the Circle C Ranch. These activities or events include but are not limited to ANY rodeo or riding activity.  I acknowledge that I am participating voluntarily and that all risks have been made clear to me.  Additionally, I do not have any physical or mental conditions that will increase my risk or likelihood of experiencing injuries while engaging in this activity.

    By signing below, I waive and forfeit any and all right to make a claim or bring a suit against Circle C Ranch Inc. for any reason.  In return, I will be allowed to participate in the activity or event occurring on or at the Circle C Ranch. I will also make every effort to obey the directions of event or activity staff and any safety precautions as provided to me in writing and as explained to me verbally. I will ask for clarification when needed.

    I further agree and accept the risk of exposure to CO-VID 19 while participating in a Circle C event or activity.  I acknowledge that it is impossible for Circle C Ranch to guarantee that every individual participating is healthy and not carrying/transmitting the virus. By signing this Waiver of Liability,  Release and Hold Harmless, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that me or my child(ren) may be exposed to or infected by COVID-19 by attending events or activities at Circle C Ranch and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death.  I understand that the risk of becoming exposed to or infected by COVID-19 at Circle C Ranch may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Circle C Ranch officers, employees, volunteers, and event or activity participants and their families.

    I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense of any kind that I or my child(ren) may experience or incur in connection with my or may child(ren)’s attendance at the Circle C Ranch event or activity (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Circle C Ranch, its officers, employees, agents, volunteers and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.  I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Circle C Ranch, its officers, employees, agents, volunteers and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Circle C Ranch activity or event.

     

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