My child is currently enrolled in ACHIEVE Afterschool, therefore I do not need to fill out an enrollment packet. I want to enroll my child in ACHIEVE Summer Camp. Furthermore, I will call the Coalition office to update my child's file with any address or telephone number changes.

(parent/guardian) wish to enroll my child in the ACHIEVE Summer Camp.

Transportation:

Upon receipt of this authorization, one of our staff will reach out to you to confirm your child's enrollment in the ACHIEVE Summer Camp and confirm transportation.

If you have any questions or concerns, please call the Levy County Prevention Coalition office at 352-328-3540

IN CONSIDERATION OF the risk and injury that exists while participating in Achieve Summer Camp and all activities, (include but not limited to, Swimming Fishing, all other indoor and outdoor recreation, indoor and outdoor academic and personal enrichment activities) (hereinafter the "Activity"); and IN CONSIDERATION OF my desire to participate in said Activity and being given the right to participate in the same

I HEREBY for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents and guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes or action of any kind arising out of my participation in the Activity, and I HEREBY release and forever discharge Levy County Prevention Coalition, associated contractors, supporting organizations, volunteers, public and private land owners, public and private facility owners, vehicle owners, and equipment owners, located at all Achieve Summer Camp sites, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releasees"), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.

I AM VOLUNTARILY PARTICIPATING IN THE AFORMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISGIFUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.

I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attomey's fees and any related costs.

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that! should require medical care or treatment, I authorize Levy County Prevention Coalition to provide all emergency medical care deemed necessary, including but not limited to, frstaid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment I am aware and understand that I should carry my own health insurance.

I FURTHER ACKNOWLEDGE that this Activity may involve a test of a person's physical and mental limits and may carry with it potential for death, serious injury, and property loss. I agree not to participate in the Activity unless I am medically able and properly trained and I agree to abide by the decision of the Levy County Prevention Coalition official or agent, regarding my approval to participate in the Activity.

I hereby acknowledge that I have carefully read this "summer camp waiver and release and fully understand that it is a release of liability. I expressly agree to release and discharge Levy County Prevention Coalition, associated contractors, public and private landowners, public and private facility owners, vehicle owners, and equipment owners and all of its affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns, from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against Levy County Prevention Coalition, associated contracted, private landowners, vehicle owners (includes ATV/UTV vehicles) and equipment owners for personal injury or property damage.

To the extent that statue or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of Levy County Prevention Coalition, associated contractors, public and private landowners, public and private facility owners, vehide owners, equipment operators, its agents, and employees.

I agree that this Release shall be governed for all purposes by Florida law, without regard to any conflict of law principles. This waiver and release of liability shall remain in effect for the duration of my participation in the activity, during this initial and all subsequent events of participation and is valid for 365 days from the time in which it was signed.

THIS AGREEMENT was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Releasor and Levy County Prevention Coalition, associated contractors, public and private landowners, public and private facility owners, vehicle owners and equipment owners agree that this agreementis dear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect Ifa court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

Parents and guardians must sign multiple release forms - "Contract of Release and Waiver, Assumption of Risk, and Indemnification" and "Summer Camp Agreement, Complete Liability Release for Minors". Signing this form does not diminish the "Contract of Release and Waiver, Assumption of Risk, and Indemnification". The "Contract of Release and Waiver, Assumption of Risk, and Indemnification" shall take precedent over all other forms should a conflict be identified amongst the forms.

You are agreeing to let your minor child engage in a potentially dangerous activity. You are agreeing that even if Levy County Prevention Coalition uses reasonable care in providing this activity, there is a chance your child may be seriously injured or killed by participating in this activity because there are certain dangers inherent in the activity which cannot be avoided or eliminated.

By signing this form, you are giving up your child's right and your right to recover from Levy County Prevention Coalition and all associated parties in a lawsuit for any personal injury, including DEATH, to your child or any property damage that results from the risks that are a natural part of the activity. You have the right to refuse to sign this form, and Levy County Prevention Coalition has the right to refuse to let your child participate if you do not sign this form.

In the event that any provision contained within the release forms shall be deemed to be severable or invalid, or if any term, conditions, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, all other terms, conditions, phrases or portions of the agreement shall remain in full force and effect.

You can, at any time, discontinue your child's participation in the Achieve Summer Camp by not sending them to camp.

THIS IS A COMPLETE LIABILITY RELEASE - BE SURE YOU UNDERSTAND THIS DOCUMENT BEFORE SIGNING

Levy County Prevention Coalition, Tartu Foundation, public and private landowners, public and private facility owners, vehicle owners and equipment owners (hereinafter collectively "Releasees") offer limited protection for the Achieve Summer Camp (hereinafter collectively, "Event"). You (hereinafter collectively, "Releasor", "I", or "me", which terms shall also include Releasor's parent and guardian if Releasor is under 18 years of age) could suffer personal injury, including DEATH, and property damage at this event or on the adjacent premises. You are being asked to sign this contract in consideration of being allowed to enter the event. Event activities include but are not limited to Water Activities, Swimming, Fishing, indoor and outdoor recreation, indoor and outdoor academic and personal enrichment activities and all other activities conducted during the Achieve Summer Camp. This contract covers any and all injuries and damages sustained by you at this event, anytime within 365 days from the date you signed this contract

The portion of this agreement, which permits you entry into the event, runs to your benefit and allows you to attend the event. The portion of this contract in which you agree to release, waiver, assume risk and indemnify runs to the benefit of this event, its owners, tenants, operators, promoters, partners, corporate entities, shareholders, members, directors, and officers of any entity, and to the benefit of all the others participating in this event, including yourself.

Until you sign your name to this document it is an offer, which you can accept or reject. By signing, you are accepting all the terms of this contract and you are binding yourself, your heirs, your assigns, this event its owners, its operators, its agents and its sponsor to those terms.

The premises referred to herein shall include, but not be limited to all the natural land, bodies of water, trees, fences, walls, and perimeter, all roadways and parking lots, all areas of ingress and egress, all buildings, restrooms and facilities, and any other parts and portions of these and adjacent premises inside the boundaries of the state of Florida.

The type of accidents, risks, and dangers which can cause you a personal injury including DEATH and/or property damage, and which are intended to be covered by this Contract of Release and Waiver, and Assumption of Risk, and Indemnification; include but are not limited to:

1. Injuries caused by nature including but not limited to water, wild animals, plants, hidden ground openings, sliding rocks, and trees;
2. Entering, exiting, servicing, driving, steering, riding, sitting in, colliding, loading or unloading, and/or crashing a vehicle;
3. Being struck, contacted, injured or being in fear of injury, even if you are a spectator, laboring or competing by any animal, vehicle, liquid, gas, fireworks, explosives, bullets or other projectiles, dirt, blacktop, stone and/or clay;
4. Being injured by rescue or attempt to rescue, whether such rescue is made on the premises or adjacent to the premises;
5. Eating, consuming, and digesting food or beverages, even if said food or beverage is defective or harmful;
6. Being injured as a result of a defective or harmful condition in some product, place, equipment, and/or services supplied to you for your use;
7. Being injured as a result of failing to be supplied some necessary equipment by releasees;
8. Being injured as a result of improper operation of a vehicle by releasees;
9. Being injured as a result of riding as a passenger on a vehicle improperly operated by releasees;
10. Being injured as a result of negligent actions by releasees;
11. For all such injuries occurring within or adjacent to these premises.

By signing at the bottom of the page, you are releasing this event, its owners, its operators, its officials, its sanctioning organization, its sponsors, and all others participating in this event for any personal injury including DEATH and/or property damage sustained by you while on the premises. The law gives you, your dependents, your assigns, and/or your estate, potential rights to sue this event its owners, its operators and the others signing this release with whom you are participating in this event, if you suffer a loss at the event. By signing this contract, you are waiving those rights and promising not to sue the event, its owners, and sponsors and other event participants for your personal injury and property damage, whether caused by your negligence, the negligence of event owners and/or operators or the negligence of others. Even if your loss is entirely the fault of the releasees, you are releasing them from any and all responsibility and liability. You are signing a complete liability release.

By signing at the bottom, you are also indemnifying this event its owners, its operators. That means that if they suffer any kind of loss or debt, which is due in whole, or in part to your fault, they can seek reimbursement from you for that portion of their loss or debt, which is due to your fault, even if they are partially at fault, too.

Preparation for, participation in, and observation of this event can be very dangerous activities, which can injure your person and damage your property, or even cause DEATH. Although you are aware of those risks, you are still voluntarily going ahead and entering these dangerous premises and participating in the event. That means that you are "assuming the risk" inherent in entering and being a part of the event and, if you suffer a loss because of those risks, you will not be allowed to make a claim against this event, its owners, sponsors, operators and other participants. If you become aware of any dangers, risks, or defects, you do not wish to assume, you are responsible for removing yourself from the premises and are still "assuming the risk" while removing yourself from the premises.

you hereby agree that you have read or have been given opportunity to read this contract and you agree that you understand it. If any paragraph or provision of this contract is deemed illegal, the rest of the document shall stand in full force and effect.

By signing this agreement, you hereby agree to follow any and all the event's rules, regulations and responsibilities, printed, published or posted, together with those rules and practices which are the custom of the event.

Upon request, you will be given a copy of this agreement.

Any dispute, controversy or claim arising out of or in connection with this Agreement or any breach or alleged breach hereof shall, upon the request of any party involved, be submitted to, and settled by, arbitration in Levy County, Florida, pursuant to the commercial arbitration rules then in effect of the American Arbitration Association (or at any other time or place or under any other form of arbitration mutually acceptable to the parties involved). Any award rendered shall be final and conclusive upon the parties and a judgement thereon may be entered in a court of competent jurisdiction. The expenses of arbitration shall be born equally by the parties to the arbitration, provided that each party shall pay for and bear the cost of its own experts, evidence and attorneys' fees, except that in the discretion of the arbitrator any award may include the attorney's fees of a party if the arbitrator expressly determines that the party against whom such award is entered has caused the dispute, controversy or claim to be submitted to arbitration as a dilatory tactic or in bad faith.

All questions concerning the construction, validity, and interpretation of this Contract and the performance of the obligations imposed hereby shall be governed by the internal law, not the law of conflicts, of the State of Florida.