Waiver and Release of Claims with Electronic Signature

In exchange for and in consideration of the opportunity for my child,    Child First Name*   Child Last Name*   to participate in Activity* and/or use the facilities for related activities on the premises of St. Basil the Great Parish Church, 8700 Brecksville Rd. Brecksville, OH 44141 (the “Activity”), I, on behalf of myself and my minor child, hereby agree to the following: 

• I understand the scope and nature of the Activity, that the Activity involves    Description of Activity*    .
• I recognize, as with any physical activity, the possibility and risk of injury associated with my child’s participation in the Activity and that such injury can include but is not limited to serious bodily injury, permanent disability, paralysis, and death.
• I understand that such injuries can occur for any number of reasons which are both foreseeable and unforeseeable and which include, but are not limited to, my child’s own actions or inaction, the actions or inaction of others (whether negligent, intentional, or otherwise), and equipment failure.
• I understand that, but with my agreement to release any claims arising out of the Activity, the Parish would not permit the use of its facilities for this program. I further understand that the Parish is not sponsoring or supervising the Activity but only allowing the use of its facilities.
• I assume all risks in connection with my child’s participation in the Activity.
• To the fullest extent allowed by law, I, on behalf of myself, my spouse, my minor child, as well as our respective heirs and assigns, executors, all other legal representatives and any others claiming through us or on behalf of us, hereby agree to release, discharge, and hold harmless the Parish, the Catholic Diocese of Cleveland, and the Bishop / Administrator of the Catholic Diocese of Cleveland, as well as their respective clergy, officers, employees, agents, representatives, attorneys, sponsors, and volunteers (“Released Parties”) forever from and against any and all claims, lawsuits, damages, judgments, expenses including attorney’s fees, liabilities (of any nature or extent), demands, damages, cause of action of any nature and kind, known or unknown, which in any way arise out of or relate to my child’s participation in the Activity (including without limitation any injury, loss, or damage to my child’s person or property or medical care provided in connection therewith), whether foreseen or unforeseen, regardless of the cause (including, but not limited to, the negligence of any person) (the “Claims”).
• I understand that it is my responsibility to carry appropriate medical insurance and that such is not the responsibility of any other person or party, including, without limitation, the Parish or Diocese of Cleveland.

By signing below I agree that I have read and fully understand this Release and agree to all of its terms.