I represent and warrant that my child/children as listed above are in good health and have no known physical conditions, ailments or other impairments which could endanger my child/children's health or safety if they were to participate in vigorous physical activity. For and in consideration of the benefits derived from my child/children's participation in the Brambleton Summer Service Day program, I assume all risks and hazards incidental to such participation, including transportation to and from such activities, and do hereby indemnify, release and hold harmless, the Brambleton Community Association, its officers, directors, employees, and agents from all claims of any kind whatsoever, which may arise or hereafter accrue in connection with participation in the activities of the Summer Service Days program.
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named participant, and are over the age of 18. In case of medical emergency or general medical care, I give consent for urgent medical teatment for the aboved named participant by authorized personnel.
I understand that the above named participant will only be released from activities as authorized above and that I will need to submit written authorization for any change to the release plan. I certify that my child has my permission to attend and participate in all activites.