Waiver, Release, and Indemnification

In consideration of the Participant’s being permitted to participate in the Activity, we do release, waive, forever discharge and covenant not to sue Mentorship Academy, its governing board, officers, agents, employees and any students acting as employees (“Releases”), from and against any and all liability for any harm, injury, damage, claims, demands, actions, causes of action, costs, and expenses of any nature which Participant or his or her Parent or Guardian, arising out of or related to any loss, damage, or injury, that may be sustained by Participant or by any property belonging to Participant or his or her Parent or Guardian, whether caused by the negligence or carelessness of the Releases, or otherwise while Participant is in, on, upon or in transit to or from the premises where the Activity, or any adjunct to the Activity occurs or is being conducted.

We further state that there are no health--related reasons or problems which precludes or restrict Participant’s participation in this Activity, and that Participant has or will have adequate health insurance necessary to provide for and pay any medical costs that may be attendant as a result of any injury to the Participant.

It is our express intent that this Waiver, Release, and Indemnification Agreement shall bind the members of Participant’s family and spouse if married. Participant and/or Participant’s parent/guardian further agree to save and hold harmless, indemnify, and defend the Releases from any claim by Participant’s family arising out of Participant’s participation in this Activity.

Participant further agrees to abide by the rules and regulations of Mentorship Academy while participating in this Activity and acknowledges and recognizes the right of Mentorship Academy, through its employees or agent, to terminate his or her participation in this Activity should (s)he not abide by the stated regulations. Participant agrees to supply a signed copy of this document to his or her parent or guardian.

We further agree that this release shall be construed in accordance with the laws of the State of Arkansas. If any term or provision of this Release shall be held illegal, unenforceable or in conflict with any law governing this Release, the validity of the remaining portions shall not be affected.

I, Participant’s Parent/Guardian further state that I am the Participant’s Parent/Guardian, and am fully competent to sign this Agreement, and that I execute this release for full, adequate, and complete consideration of my own free act and deed, fully intending for myself, for the Participant and for the Participant’s family, estate, heirs, personal representative or assigns to be bound by the same. No oral representation, statements, or inducements, apart from the foregoing have been made.

 

Medical/Health Release/Authorization: I hereby accept financial responsibility for the expense of health care services and I authorize the medical providers of Mentorship Academy Student Health Services and their agents or consultants, including emergency medical technicians, area hospitals or other treatment facilities, to perform diagnostic and treatment procedures, on the below named student, which in their judgment may become necessary while he/she attends Mentorship Academy events. 

I have no expectation for Mentorship Academy to pay medical expenses for the student should he/she need treatment outside of Student Health Services.

I agree to absolve and hold harmless Mentorship Academy in making medical decisions for the student.

I understand that every effort will be made to notify the parent or legal guardian once permission is obtained from the student in the event of a major illness or injury. 

I understand that the parent or guardian may not necessarily receive notification prior to treatment.

Waiver and Release. You hereby release and forever discharge and hold Mentorship Academy and its agents from any and all liability, claims and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from your child’s participation in activities associated with Mentorship Academy due to the COVID-19 pandemic. You understand that this Mentorship Academy from any liability or claim that you may have against the Mentorship Academy with respect to any bodily injury, personal injury, illness, or other issue that may result from your child’s participation, whether caused by the negligence of Mentorship Academy or by the negligence of others, or by the condition of the facilities or areas where Mentorship Academy activities are being conducted.

Assumption of Risk. You further understand that your child’s participation may expose him/her and others to unavoidable COVID-19 community spread. As such, you hereby expressly and specifically assume the risk of injury or other harm, and also expressly release [enter school] from all liability for injury, illness, or other issue resulting from or in any way related to your child’s return or participation.

BY EXECUTING BELOW, YOU ACKNOWLEDGE HAVING READ AND UNDERSTOOD ALL OF THE ABOVE-TERMS AND CONDITIONS.
THIS IS A RELEASE OF LEGAL RIGHTS, READ BEFORE SIGNING.

No student will be allowed to participate in the Mentorship Academy Program unless this form has been received prior to or upon arrival, or otherwise designated by the Program Director. If you have not already done so, please return the form to the Director of the Program in which you will participate.