Kid City Program Waiver Statement
I understand that this waiver is valid from June 1, 2022 through May 31, 2023. I understand that my child may be photographed or videotaped during his/her participation in this activity, and consent to the reproduction of such photos or videos electronically, in print, and in social media for advertising and publicity purposes. I give permission for my child to attend all field trips as part of Break Days and Kid City Summer Camp programs. The undersigned is the parent or legal guardian of the program participant. The undersigned hereby states that s/he understands the activities that will take place in this program, and that the program participant is physically and mentally able to participate in this program. The undersigned recognizes, as with any activity, there is risk of injury. In the event that the program participant sustains an injury in the course of the program, and the Bloomington Parks and Recreation Department is unable to contact the appropriate person(s) to obtain consent for treatment, the Department and/or its employees or volunteers are authorized to take reasonable steps to obtain appropriate medical treatment. The program participant and/or his/her parent or legal guardian shall be responsible for the cost of such treatment. The undersigned now releases the City of Bloomington, the Bloomington Parks and Recreation Department, its employees, agents, and assigns, from any claims including, but not limited to, personal injuries or damage to property caused by or having any relation to this activity. It is understood that the release applies to any present or future injuries and that it binds the undersigned, undersigned’s spouse, heirs, executors and administrators.
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is highly contagious and is believed to spread mainly from person-to-person contact. Bloomington Parks and
Recreation Department has put in place preventative measures to reduce the spread of COVID-19; however, the Department cannot guarantee that the program participant, or the program participant’s household members will not become infected with COVID-19. Further, attending the program could increase the risk of the program participant, or the program participant’s household members of contracting COVID-19.
By signing this agreement, the undersigned acknowledges the contagious nature of COVID-19 and voluntarily assumes the risk that the program participant, or other members of the program participant’s household may be exposed to or infected by COVID-19 as a result of attending the program and that such exposure or infection may result in personal injury, illness, permanent disability, and death. The undersigned also acknowledges and understands that all of the risks of COVID-19 are not known and that the risk of becoming exposed to or infected by COVID-19 at the program may result from the actions, omissions, or negligence of the program participant and others, including, but not limited to, Bloomington Parks and Recreation employees, volunteers, and other program participants and their families. The undersigned voluntarily agrees to assume all of the foregoing risks, known and unknown, and accept sole responsibility for any injury or loss to the program participant, and other members of the program participant’s household. The undersigned hereby waives, releases, discharges, and agrees to hold harmless, indemnify, and not sue Bloomington Parks and Recreations Department, its employees, agents, officers, directors, affiliates, members, volunteers, and representatives (collectively, “Releasees”), of and from any and all claims, liabilities, actions, damages, costs or expenses of any kind arising out of or relating thereto. The undersigned further agrees that this release includes any Claims based on the actions, omissions, or negligence of the Releasees, whether such claim arises before, during, or after participation in any Parks and Recreation program.