It is important to follow the instructions of the staff and volunteers in charge of the programs at all times. I must also abide by the Iowa State University Extension and Outreach standards and expectations of conduct. I understand that, as a participant, I have a responsibility to help make the learning opportunity a safe experience for all through my behavior and conduct. I also agree to follow the rules and instructions and understand the danger of not doing so. I agree to abide by the Iowa 4-H Youth and Families Code of Conduct found at the following link: https://iastate.box.com/v/webdoc4HP3410.
During the program and associated activities, photographs and video or audio recordings in which you appear may be taken. In addition, during virtual programs, your location, surroundings or other personal information may be electronically captured and displayed. Your name entered below shall be deemed permission for IowaStateUniversity Extension and Outreach and faculty or staff to photograph, film, audio or video record, record, or televise your image or voice for use in any publication or promotional material, in any means now known or hereafter developed, without any additional restriction or consideration. If you object to IowaStateUniversity ExtensionandOutreach using your likeness or voice in this way, please notify faculty or program staff in writing before you participate. Waiver of Disclaimer: I give my permission for myself or my children to participate in the Iowa 4-H program. I understand that 4-H club project activities or events may involve certain physical risks and possible injury and that Iowa State University (ISU) and your 4-H program will provide each participant with reasonable care. However, I understand that ISU cannot guarantee that I or my child
we suffer injuries.
In addition, some 4-H projects, including but not limited to shooting sports, equestrian or ranching projects, aquatics, and other sporting activities, present a higher degree of risk. However, I want my child or I to participate as members of the Iowa 4-H club in the 4-H club program and I ASSUME the RISK of participating. I hereby AGREE NOT TO SUE the State of Iowa; to the Iowa State Board of Regents; Iowa State University; to IowaStateUniversityExtension andOutreach; nor to the County Agricultural Extension District; as well as their respective officers, employees, agents and volunteers (the “Releases”) and I release them from all liability, claim or cause of action arising out of or related to any loss, damage or injury, including death, that may be suffered by me or my child, or suffered by my property, and which is the result, in whole or in part, of my own or my child's participation in the Program, as permitted by law to the fullest extent. Further, the undersigned, on behalf of himself and his personal representatives, heirs, assigns, and next of kin, AGREES TO INDEMNIFY AND RELEASE Releasees from all liability for injury, including sickness, disability, and death, and loss or damage to property. property that may result from, arise from, or be connected with my or my child's participation in the Program, as permitted by law to the fullest extent. I HAVE READ THIS AGREEMENT IN ITS ENTIRETY AND UNDERSTAND ITS TERMS, AND I UNDERSTAND THAT I HAVE WAIVED MY RIGHTS SUBSTANTIAL SIGNATURES AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INCENTIVE OF ANY KIND.
I understand and agree that my child (participant named above) is healthy and reasonably fit enough to safely participate in the Iowa 4-H program. I understand and agree to report to program leaders any condition that may impair my ability to child to safely participate in the program, as well as work with program leaders to develop a written safety plan regarding my student if I have such concerns. I recognize that there may be times when my child may require first aid or emergency medical or dental treatment as a result of an accident, illness or other health condition or injury. I therefore authorize Iowa State University (the University), IowaStateUniversity ExtensionandOutreach staff, County Agricultural Extension District staff, representatives and volunteers to
provide routine first aid and seek emergency medical treatment for my child, including consent for x-rays, examinations, and other medical diagnosis and treatment. I agree to accept full responsibility for any and all expenses, including medical expenses that may result from any injury to my child that may occur while participating in the program. As the parent or legal guardian of the minor, I am authorized to consent to the services to be provided and declare that my consent and agreement to pay for medical or hospital care or treatment is legally sufficient and will not be requires the consent of no other person. I further agree to hold harmless and indemnify the State of Iowa, the Iowa State Board of Regents, the University, IowaStateUniversity Extension and Outreach, and the County Agricultural Extension District, and their staff, representatives and volunteers, for any claim, cause of action, damages or liability, arising out of or resulting from such medical treatment.