Please read the following agreement. Sign and date.
RELEASE, PERMISSION & POLICY AGREEMENT
We are required to inform you that our summer camp program is not required to be licensed as a child care center by the State of Georgia. Therefore we have received an exemption from the license requirement by the State. We operate independently of the State of Georgia.
THIS RELEASE PERMISSION AND POLICY AGREEMENT (“Release”) is given by the undersigned parent of legal guardian of ______________________________________________________________________________ (“My Child(ren)”) in favor of Clarkston Community Center Foundation, Inc., its officers, directors, employees, agents, volunteers, affiliated assosications, organizers, sponsors, participants and person supervising or transporting participants (collectively referred to as “Clarkston Community Center”). In consideration of My Child[ren] being allowed to enroll in and participate in Clarkston Community Center’s program known as the “Clarkston STEAM-Plus Summer Camp,” I hereby agree as follows:
RELEASE OF LIABILITY. To the fullest extent permitted by law, I hereby agree for myself, my heirs, assigns, executors and administrators to waive, release, discharge, indemnify, defend and hold harmless Clarkston Community Center, from and against any and all claims, demands, causes of action, liabilities, damages, costs and expenses, including attorney’s fees for bodily injury the COVID-19 disease/virus, disease, death, or damage to property arising out of or resulting from my child's or children's participation in Clarkston Community Center’s sponsored activities, provided that nothing set forth herein will require that I indemnify Clarkston Community Center for the consequences of his, her or its sole negligence. I agree that my providing the Release is a material inducement Clarkston Community Center, allowing me to participate in Clarkston Community Center, sponsored activities and that allowing my participation is good and adequate consideration for the Release.
PERMISSION. I hereby give permission to Clarkston Community Center for my My Child[ren] to participate in activities, programs and excursions of Clarkston Community Center, including without limitation, the summer camp activities sponsored by partners and presenters, and I further give permission for Clarkston Community Center to transport or to arrange for third parties to transport My Child[ren] to, from and during the Activities. I understand that the Activities involve a certain degree of risk. I have carefully considered the risk involved and hereby give consent for My Child[ren] to participate in the Activities. Further, I agree that Clarkston Community Center does not assume any liability for any personal or bodily injury, property damage or death to My Child[ren] while participating in the Activities, and I assume all risks and hazards incident to the Activities. I further state that my child[ren] is in proper physical condition to complete all Activties and further agree that Clarkston Community Center is under no obligation to provide physical examination or other evidence of My Child[ren]’s fitness to participate in any of the Activities.
CONSENT FOR MEDICAL TREATMENT. I understand that Clarkston Community Center does not have medical personnel available at the location of the sponsored activities. I understand and agree that Clarkston Community Center is granted permission to authorize emergency medical treatment, if necessary, and that such action by Clarkston Community Center shall be subject to the terms of this Release. I understand and agree that Clarkston Community Center shall have no responsibilities for any injury or damage which might arise out of, or in connection with, such authorized emergency medical treatment.
By signing, I hereby warrant and represent that I am the legal parent or guardian of My Child and that I have read, understand and agree to the terms and conditions set forth above. I agree to release, discharge, indemnify, defend and hold harmless Clarkston Community Center from and against any and all claims, demands, causes of action, liabilities, damages, costs and expenses, including attorney’s fees arising out of or resulting from breach of the foregoing warranty and representation.
I have carefully read this Participant, Release, Waiver and Policy Agreement and fully understand its contents. I am aware that this is a release of liability and a contract between Clarkston Community Center and myself and I sign it of my own free will.