The undersigned parent/guardian desires to allow his or her child (“Participant”) to participate in a camp/afterschool program at Washington Township (“Program”). Participant and parent/guardian understand and acknowledge that participation in this Program is voluntary. In exchange for being permitted to participate in Program, Participant and parent/guardian agree to this full Waiver and Release.
Participant and parent/guardian understand and acknowledge that there are risks inherent in participating in this Program, including possible personal injury, injury to property, or death. Participants and parent/guardian agree to make themselves aware the risks and hazards associated with this Program. Parent/guardian expressly acknowledge and agree that it is the responsibility of parent/guardian to inform Participant of any potential risks involved in Program activities. Participant and parent/guardian acknowledge that the activities involved in Program may include (but are not limited to) various types of physical exertion, running, and other conduct involved in physical activity. As a result, thsi Program may result in serious injuries, including injury to the head or brain, injury to all internal organs, injury to all bones, joints, muscles, ligaments, tendons, and other aspects of the muscular-skeletal system, any other injury to any part of the body, or death. In addition, this Program will involve field trips to various locations, each involving unique risks to this Participant, including risk of injury during transportation to the field trip. Participant and parent/guardian acknowledge and understand that there is a possibility of unforeseen and unpredictable events and risks inherent in this Program that can result in serious bodily injury or death when participating in this Program. Participants and parent/guardian further understand that there may be other risks in addition to those listed above that may pose a danger to Participants and other individuals, and Participant and parent/guardian expressly assume all risks, known and unknown, including risks posed by field trips. For purposes of this Waiver and Release, “Program” includes all field trips and any other Program-related activities.
With the above in mind, and being fully aware of the risks (known and unknown) and possibility of injury and loss involved, the undersigned Participant and parent/guardian consent to have Participant participate in this Program. Parent/guardian, on behalf of himself/herself, any other parent/guardian, Participant, executors or other representatives, waive and release all rights and claims for damages that the parent/guardian or Participant may have against Washington Township and its representatives, agents, members of the board of trustees, employees, representatives, and volunteers (collectively, “Washington Township”). By signing this Waiver and Release, Participant and parent/guardian agree to waive, release and hold harmless Washington Township and its agents, members of the board of trustees, employees, representatives and volunteers from any and all present and future claims, lawsuits, actions, liabilities, demands, damages, costs, expenses, loss of services, actions and causes of action whatsoever for, upon, or by reason of, any present or future loss, injury, disability or damage of any kind whatsoever (whether to person, including death, or to property, and whether negligent or otherwise), known or unknown, anticipated or unanticipated, at any time arising out of or relating in any way to the activities involved in this Program or for any treatment of injury sustained during this Program. This Waiver and Release expressly includes any claims arising from or relating to the administration of medication by Washington Township. Participant and parent/guardian further agree to indemnify, defend, and hold Washington Township free and harmless from and against all present and future claims, lawsuits, damages, costs, expenses, loss of services, actions and causes of action, including actions for loss of life, whether known or unknown, anticipated or unanticipated, arising out of or relating in any way to this Program or related activity.
The undersigned parent/guardian also affirms that Participant now has and will continue to maintain proper hospitalization, health, and accident insurance coverage which the undersigned acknowledges as adequate for both Participant’s protection and the parent/guardian’s own protection. Participant is covered by primary health/medical/accident insurance (please list provider below). Participant and parent/guardian represent and warrant that Participant is qualified, in good health, and in proper physical condition to participate in this Program and all activities associated with this Program.
Agreement to this Waiver and Release is voluntary and in exchange for permission of Particiapnt to participate in this program. Participant and parent/guardian acknowledge that they have been provided sufficient time to read and consider the nature and scope of this Waiver and Release. It is the intent of the undersigned that this Waiver and Release be complete and unconditional and be applied to the fullest extent permitted by law. If any part or portion of this Waiver or Release is held invalid, the remainder shall continue in full force and effect.