LAWRENCE COUNTY COMMUNITY ACTION PARTNERSHIP
WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT
1. In consideration for participating in the a Summer Day Camp Program at the Frew Mill Campus, I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Lawrence County Social Services., Inc., and/or Allied Coordinated Transportation Services, Inc., their officers, servants, agents, and employees (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by a Participant, or to any property belonging to the Participant, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise, while participating in such activity, or while in, on or upon the premises where the activity is being conducted or in transportation to and from said premises.
2. Parent/Guardian consents to Participant’s participation in the activity and is physically capable of participating in the activity. To the best of Participant’s and Parent/Guardian’s knowledge, the Participant can fully participate in this activity. The Participant and Parent/Guardian is fully aware of risks and hazards connected with the activity, including but not limited to the risks as noted herein, and hereby elects to voluntarily participate in said activity, and to enter the above-named premises and engage in such activity knowing that the activity may be hazardous to the Participant and his/her property. The Participant and Parent/Guardian VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by the Participant, or any loss or damage to property owned by the Participant, as a result of being engaged in such an activity, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or otherwise.
3. The Participant and Parent/Guardian further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS THE RELEASEES from any loss, liability, damage or costs, including court costs and attorney’s fees, that may incur due to the Participant’s participation in said activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise.
4. It is the Participant’s and Parent/Guardian’s express intent that this Release and Hold Harmless Agreement shall bind the Participant and members of the Participant’s family, including but not limited to the Parent/Guardian, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above named RELEASEES. The Participant and Parent/Guardian hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Pennsylvania.
5. THE PARTICIPANT AND PARENT/GUARDIAN UNDERSTAND THAT THE LAWRENCE COUNTY SOCIAL SERVICES, INC. WILL NOT BE RESPONSIBLE FOR ANY MEDICAL COSTS ASSOCIATED WITH AN INJURY A PARTICIPANT MAY SUSTAIN.
6. THE PARTICIPANT AND PARENT/GURDIAN also understand that THE PARTICIPANT AND/OR PARENT/GUARDIAN IS responsible for any damage THE PARTICIPANT causes to the facilities.
7. Where applicable, the Participant and Parent/Guardian further grant to Lawrence County Social Services, Inc., and/or Allied Coordinated Transportation Services, Inc., its designees and successors, Participant’s and Parent/Guardian’s consent to the Participant’s name, photograph, likeness, image, voice and biography in any publications, advertising, and publicity, in connection with Participant’s participation in a Summer Day Camp Program. *
IN SIGNING THIS RELEASE, I (Parent/Guardian), ACKNOWLEDGE AND REPRESENT THAT (Parent/Guardian) have read the foregoing Waiver of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my/our own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreement, have been made; (Parent/Guardian) execute this Release for full, adequate and complete consideration fully intending to be bound by same.
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