Circle Recreation Participation Waiver

Participation Waiver And Release Form

Parent/Guardian must fill out Participation Waiver for Children under 18 years of age
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Participant Name

First NameLast Name
DOB

MonthDayYear
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Circle Recreation Commission General Activity Waiver
By signing below, I acknowledge and agree to the following:

Assumption of Risk:
I understand that participation in Circle Recreation Commission activities involves inherent risks, including, but not limited to, injuries resulting from falls, equipment use, contact with other participants, weather conditions, and the actions of others. I assume full responsibility for my participation in these activities.

Release of Liability:
I, on behalf of myself, my heirs, assigns, and personal representatives, hereby release and hold harmless Circle Recreation Commission, USD 375, its employees, volunteers, sponsors, and agents from any and all liability, claims, or demands for personal injury, property damage, or any other loss or harm arising from my participation in any Circle Recreation program or activity, except in cases of gross negligence or willful misconduct.

Medical Treatment Authorization:
In the event of an emergency, I authorize Circle Recreation Commission staff, coaches, or volunteers to seek appropriate medical care for me if I am unable to do so. I agree to be financially responsible for any costs incurred as a result of such care.

Media Release:
I grant Circle Recreation Commission and USD 375 permission to photograph, video record, or otherwise capture images of me during participation in Circle Recreation activities. I understand that these images may be used for promotional purposes, including but not limited to, social media, websites, printed materials, and local news coverage. I waive any rights to compensation or ownership of these images.
Participant Signature

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Today's Date

MonthDayYear
Date
Child's name

First NameLast Name
Child's DOB

MonthDayYear
Date
Parent/Guardian name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.
Circle Recreation Commission General Activity Waiver
By signing below, I acknowledge and agree to the following on behalf of my child:

Assumption of Risk:
I understand that participation in Circle Recreation Commission activities involves inherent risks, including, but not limited to, injuries resulting from falls, equipment use, contact with other participants, weather conditions, and the actions of others. I assume full responsibility for my child’s participation in these activities.

Release of Liability:
I, on behalf of myself, my child, and our heirs, assigns, and personal representatives, hereby release and hold harmless Circle Recreation Commission, USD 375, its employees, volunteers, sponsors, and agents from any and all liability, claims, or demands for personal injury, property damage, or any other loss or harm arising from my child’s participation in any Circle Recreation program or activity, except in cases of gross negligence or willful misconduct.

Medical Treatment Authorization:
In the event of an emergency, I authorize Circle Recreation Commission staff, coaches, or volunteers to seek appropriate medical care for my child. I agree to be financially responsible for any costs incurred as a result of such care.

Media Release:
I grant Circle Recreation Commission and USD 375 permission to photograph, video record, or otherwise capture images of my child during participation in Circle Recreation activities. I understand that these images may be used for promotional purposes, including but not limited to, social media, websites, printed materials, and local news coverage. I waive any rights to compensation or ownership of these images.
Participant Signature

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Today's Date

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Date
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Participation Waiver And Release Form