Release of Liability: In consideration for participation in services provided by Acclaim Autism, Client and Parent release from liability and waive Client’s and Parent’s right to sue Aspire Autism Inc. doing business as Acclaim Autism, and Acclaim Autism LLC, (each referred to as “Acclaim Autism”), their employees, officers, volunteers and agents from any and all claims, including claims of Acclaim Autism’s negligence, resulting in any physical injury, illness (including death) or economic loss Client or Patient may suffer or which may result from participation in services, travel to and from service locations, or any events incidental to services.
Hold Harmless: Client and Parent agree to hold Acclaim Autism harmless from any and all claims, loss or damage to personal property, liabilities and costs, including attorney’s fees, as a result of participation in services, including travel to and from service locations (including air travel) or any events incidental to services being rendered. If Acclaim Autism incurs any of these types of expenses, Client or Parent agrees to reimburse Acclaim Autism.
Understanding and Acknowledgement: Parent and Client have read this document, and are signing it freely. Parent understands the legal consequences of signing this document, including (a) releasing Acclaim Autism from all liability, (b) waiving Client’s and Parent’s right to sue Acclaim Autism, (c) and assuming all risks of participating in services, including travel to and from service locations (including air travel) or any events incidental to services, and risks associated with physical spaces where services may be provided in community locations on Acclaim Autism’s premises.
Medical Consent: If Client or Patient needs medical treatment as a result of participation in services, travel to and from the service location (including air travel), or any events incidental to services, Client agrees to be financially responsible for any costs incurred as a result of such treatment. Client is aware that Acclaim Autism Inc. does not provide health insurance for me and that I should carry my own health insurance.
Consent for Minor: Parent consents as the parent or legal guardian of the Client. Parent has read this document, and signing it freely. Parent understands the legal consequences of signing this document, including (a) releasing Acclaim Autism from all liability on Client’s and the Parent’s behalf, (b) waiving Client’s and the Parent’s right to sue Acclaim Autism, (c) and assuming all risks of Client’s participation in services, including travel to and from the service location (including air travel) or any events incidental to services including events at physical locations where services are provided. Parent allows the Client to participate in services. Parent understands they are responsible for the obligations and acts of the Client as described in this document. Parent agrees to be bound by the terms of this document. Parent agrees they are legally responsible and able to consent for Patient’s healthcare.
Entire Agreement: This Agreement, including Exhibits attached hereto, is the entire agreement between the parties relating to the subject matter addressed herein and supersedes all prior representations, inducement, promises or agreements, whether oral or written.
Severability: If any term, provision or covenant of this Agreement is held invalid, illegal or unenforceable for any reason, the remainder or this Agreement shall remain in full force and effect and shall in no way be affected, impaired, or invalidated as a result of such a decision.
Child Pickup: I agree to pick up my child at the end time of each session indicated on the first page of this document.
Cancellation Policy:
Cancellations must be communicated with at least 24 hours' notice.
Three or more cancellations may result in removal from the Holiday Program.
Parents agree to adhere to all additional policies as outlined at the place of service or in other official Acclaim Autism communications.
Parent confirms they are a parent or legal guardian that is authorized to consent for the above client / patient’s healthcare, and there are no court judgements or pending court cases that may decide otherwise.