Authorization
Please read and sign below.
Registration forms cannot be accepted without a signature! I understand that the programs are provided by The Town of Flagler Recreation Department, and understand the potential for accidents involved with my child’s participation in these programs, including the risk of personal injury and/or damage to my child while participating in these programs. I further understand and acknowledge that The Town of Flagler will not allow participation in these programs absent my signing this release. I authorize and grant permission for a representative of the Town of Flagler to treat minor injuries including scrapes, small cuts, splinters, and insect bites. I authorize and grant permission for a representative of The Town of Flagler to obtain emergency medical care from any ambulance service, licensed physician or hospital and/or medical clinic should my child become ill or injured while participating in educational/recreational activities away from home or at other times when neither parent nor guardian is available to grant authorization for emergency treatment. I therefore freely and voluntarily execute this release with such knowledge, assume the risk of personal injury and/or property loss arising from or in any way connected with participation in any educational/recreation
programs offered by the Town of Flagler. I hereby release and dischargeThe Town of Flagler and any and all agents of the Town of Flagler from any liability, claim, cause of action, demand or damages from injury or damages of any kind to my child or my property as a result of participation in the educational/recereational of the Town of Flagler. I grant permission and understand that photos and other images taken during this event could be used in print advertisement and other forms of media. I further waive, release, absolve and agree to indemnify and hold The Town of Flagler harmless as a result of participation in any educational/recreation programs sponsored by The Town of Flagler. I agree that my child will abide by the Parents Night Out rules or will not continue in participation. In this case I or my emergency contact may be contacted to come and pick up my child.