I/we, the parents/guardians of the above names candidate for membership in ROSEVILLE PAL (RPAL), hereby give my/our approval to his/her participation in any and all PAL activities during the current season. I/we do hereby assume all risks and hazards incidental to such participation including transportation to and from activities. I/we do hereby waive, release, absolve, indemnify and agree to hold harmless, the City of Roseville, Roseville PAL, the respective sanctioning associations, organizations, or leagues and the organizers, sponsors, supervisors, participants, and persons transporting my/our child to and from activities, for claims arising out of injury to my/our child. Roseville PAL has group accident insurance coverage for medical and hospital expenses, with a deductible for each accident. The insurance is secondary when there is any other valid and collectible insurance provided by parent/guardian. Limited coverage is provided for any one accident with limited dental coverage for sound, natural teeth. A copy of the policy is available for inspection at the RPAL office. Roseville PAL Candidate have read and understand the above Parental Consent, Insurance Information Clause, and Medical Treatment Authorization. By signing this registration form, I/we grant permission for my/our child to participate in all officially recognized RPAL activities. In signing the foregoing release, I/we acknowledge that: (1) any claim for medical service which arises out of an injury must be reported to an RPAL league official within thirty (30) days of the date of injury; (2) I/we have read the forgoing release, understand it and signed it voluntarily. I/we further understand that any registration fee or other sums paid does not constitute a direct premium payment for insurance. In the event of injury to my/our child, I/we hereby grant authority to a qualified physician to render such medical treatment as said physician deems necessary under the circumstances.
I, the parent/guardian of child mentioned above agree to allow my child to participate in the activities offered including associated travel and trips. I am aware this activity is inherently dangerous and am voluntarily allowing my child to participate in the activity with knowledge of the risks involved, both expected and unexpected, and herby agree to accept and all risks or injury or death.
In return for the benefits from my child’s participation, I agree not to sue and release and hold harmless the City of Roseville, Roseville PAL, their officers, directors, employees, agents and volunteers from any liability for any loss, injury, or death connected with my child’s participation in the activity except for loss, injury, or death caused intentionally or by willful misconduct. The Roseville Police Activities League reserves the right to photograph facilities and program participants for promotional purposes. On behalf of my child, I agree to the use of any such photographs in which he/she may appear. Photographs may be used in brochures, displays with press releases, on the City of Roseville Department website, any social media website, or the Roseville PAL website. Individuals may submit their photos for consideration.
This release is intended to protect the city of Roseville, Roseville PAL, their officers, directors, employees, agents, and volunteers from claims of negligence. However, this release is not intended to exempt them from responsibility for willful or intentional acts or omissions which result in loss, injury, or death. I have carefully read this release of liability and assumption of risk agreement. I fully understand its contents and implications. I am aware that this is a release of liability, hold harmless agreement and assumption of risk agreement and that it is a legally binding contract between the city of Roseville, Roseville PAL, myself, and my child. I further understand that this release is binding on my heirs, personal representatives, next to Kin, spouse, domestic partner, and assigns. I sign this agreement of my own free will.