CPC Waiver of Liability

Release of Liability

By signing this Permission/Waiver Form, I expressly warrant that the child named above or I, if I am a participant, am capable of withstanding both the physical and mental demands of the activities included in the Justice Club Celebration at Surge Adventure Park. I also expressly assume all risks of the child or me participating in the activities, whether such risks are known or unknown to me at this time. I further release Crisis Pregnancy Center of Tidewater (CPC) and its employees, volunteers, and agents from any claim that my child may have or that I may have against them as a result of injury or illness incurred during the course of participating in the activities. This release of liability shall include (without limitation) any claims of negligence or breach of warranty. This release of liability is also intended to cover all claims that members of the child’s or my family or estate, heirs, representatives, or assigns may have against Crisis Pregnancy Center of Tidewater (CPC) or its employees, volunteers, or agents.

I further agree to indemnify and hold harmless Crisis Pregnancy Center of Tidewater (CPC) and its employees, volunteers, or agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness of my child during such activities.

First Aid and Emergency Medical Treatment

I recognize that there may be occasions where the child named above or I, if I am a participant, may be in need of first aid or emergency medical treatment as a results of an accident, illness, or other health condition or injury. I do hereby give permission for agents of Crisis Pregnancy Center of Tidewater (CPC) to seek and secure any needed medical attention or treatment for the child named above or me, if I am a participant, including hospitalization, if in the agent’s opinion such need arises. In doing so I agree to pay all fees and costs arising from this action to obtain medical treatment. I give permission for attending physician(s) and other medical personnel to administer any needed medical treatment, including surgery and, again, I agree to pay for the medical treatment.

Photo Release

I hereby grant Crisis Pregnancy Center of Tidewater (CPC) permission to reproduce, publish, circulate, copyright, or otherwise use any and all photographs and/ or videotape of me and/ or my child taken at the Justice Club Celebration for promotional use by the organization.

Terms of Agreement

I understand that this agreement is binding throughout the entire Justice Club Celebration event at Surge Adventure Park on Saturday, June 29, 2024. The undersigned further expressly agrees that this agreement is intended to be as broad and inclusive as is permitted by the laws of this state and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

By signing this document, I understand that I may be found by a court of law to have forever waived my and my child's right to maintain any action against Crisis Pregnancy Center of Tidewater (CPC) on the basis of any claim from which I have released Crisis Pregnancy Center of Tidewater (CPC) and any released party herein and that I have assumed all risk of damage, loss, personal injury, or death to myself and/or my minor child and agreed to indemnify and hold harmless Crisis Pregnancy Center of Tidewater (CPC)from and against any and all losses, liabilities, claims, obligations, costs, damages and/or expenses whatsoever paid, incurred and/or suffered as a result in participation in the Justice Club Celebration.

I represent that I am the parent/legal guardian of {childsName} who is under 18 years of age. I have read the "Waiver of Liability - Justice Club Celebration 2024" document in its entirety and am fully familiar with the contents thereof.

I give permission for the child named on page one to participate in the activities of Crisis Pregnancy Center of Tidewater's (CPC) Justice Club Celebration at Surge Adventure Park. In consideration for allowing the participation of the child in the activities included, I hereby consent to the waiver of liability, including the Release of Liability on page one, on behalf of the child, and agree that this waiver of liability shall be binding upon me, my family, heirs, legal representatives, successors, and assigns.

By selecting "Submit" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document is as valid as if you signed the document in writing.