Minor Release Form

Keyport Hooks and Hope Minor Participant Waiver

Minor Participant Waiver, Release of Liability, and Indemnity Agreement
Child’s Full Name

First NameLast Name
Child’s Age
Child’s Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Child’s Date of Birth

MonthDayYear
Date
Parent/Guardian Full Name

First NameLast Name
1. Activities
I give permission for my child to participate in Keyport Hooks and Hope activities, including pier/shore fishing, small boat outings, and private charters on the Keyport Princess.

2. Assumption of Risk
I understand these activities involve risks such as drowning, falling, cuts, boating accidents, and weather-related hazards. I voluntarily assume all risks on behalf of my child.

3. Release of Liability
I release Keyport Hooks and Hope, its founder Bill Greaux, volunteers, the Keyport Princess crew, and all affiliated parties from any claims, liability, injury, loss, or damage arising from my child’s participation.

4. Medical Authorization
In case of emergency, I authorize group leaders to seek medical treatment for my child. I agree to pay all medical costs.

5. Photo/Video Release
I allow Keyport Hooks and Hope to use photos and videos of my child for promotional purposes.

6. Rules
I agree my child will follow all safety rules and instructions.
Emergency Contact Phone

Area CodePhone Number
Emergency Contact Name
Phone

Area CodePhone Number
Email
example@example.com
Parent/Guardian Signature
Date

MonthDayYear
Date
Should be Empty:

Keyport Hooks and Hope Minor Participant Waiver