I hereby give my permission for my child to participate in the Play Pan Afrikan Kids LLC Summer Enrichment Program.
I understand that camp activities could include play and outdoor activities around and near the Play Pan Afrikan grounds, hikes and walks in
the woods wherein there could be mosquitos, bees, ticks, poison ivy, and slippery and jagged surfaces among other dangers and risks. I also understand
that my child may travel by school van and/or metro to local sites and be walking along downtown streets and in public and private museums and
historical sites. I also understand that outdoor activities may occur in the hot sun and in the rain. I agree to see that my child is appropriately attired for
camp activities, and to provide insect repellant and sunscreen for my child to use at camp. I will not expect Play Pan Afrikan Kids LLC to provide
these items. I give my permission for Play Pan Afrikan Kids LLC leaders to apply or assist with the application of the repellant and sunscreen I
In the event of illness, injury, and/or accident, I authorize the program instructor or any Play Pan Afrikan Kids LLC employee to act on my behalf. They
may approve any and all non-emergency or emergency treatment and are authorized to sign any and all medical release or required form(s) on my
behalf. In the event of an emergency, I understand that I will be notified of the situation as soon as practicable. I agree to pay any necessary expenses not
covered by Play Pan Afrikan Kids LLC's student accident policy incurred in the medical treatment of my child, including, but not limited to all
transportation costs to and from a medical facility, and, if necessary, transportation to my home or medical facility of choice.
I understand that Play Pan Afrikan Kids LLC may, in its sole discretion, dismiss any program participant for inappropriate, disrespectful, or dangerous
behavior at any time. In this event, I understand that I will not receive a refund of program fees for unattended days. If my child breaks or damages any
property as a result of their direct or indirect behavior, I hereby agree to pay for its repair or replacement.
I understand that the risks associated with program activities could result in injury and/or death to my child. I hereby assume these risks and, knowing them,
hereby give my child permission to participate. I understand that Play Pan Afrikan Kids LLC is not liable for any injuries or other occurrences due
to indoor and outdoor camp activities or related risks, and/or the actions or omissions of Play Pan Afrikan Kids LLC counselors, volunteers,
employees, trustees, directors, officers, or any other entities being released.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in
which my child may participate, and that it will govern the actions and responsibilities at said activity.
In consideration of my application and permitting my child to participate in this activity, I hereby:
WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of Play Pan Afrikan Kids LLC, its trustees, officers, employees, camp counselors, volunteers, entities or other persons released, for my child’s death,
disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to them including their traveling to and
from this activity;
INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE Play Pan Afrikan Kids LLC, its trustees, officers, employees, volunteers, or
other entities or persons released from any and all liabilities or claims made as a result of participation in this activity, whether caused by the
negligence of release or otherwise.
I understand that while participating in this activity, my child may be photographed unless previously specified in writing by child's guardian. I agree to allow their photo, video, or film likeness to be used for
any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns unless otherwise previously stated in writing by child's guardian.
The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under
applicable law. Play Pan Afrikan LLC, its Trustees, directors, officers, and all its employees, acting officially or otherwise are hereby released
from any and all claims, demands, actions, or causes of action on account of any injury to my child that may occur. This release binds my heirs,
executors, administrators, and/or assigns.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, FULLY UNDERSTAND ITS CONTENT, AND AGREE TO ITS TERMS.