SAGE Center Educational Visit Registration

LIMITED LIABILITY STATEMENT PER CHILD FOR ATTENDANCE TO SAGE CENTER STEAM FIELD TRIPS AND CAMPS To the extent permitted by law, and in consideration for being allowed to participate in the STEAM FIELD TRIPS/CAMPS, I hereby save, hold harmless, discharge and release the STEAM FIELD TRIPS/CAMPS AND SPONSORS from any and all liability, claims, causes of actions, damages or demands of any kind and nature whatsoever that may arise from or in connection with my participation in any activities related to the STEAM FIELD TRIPS/ CAMPS, whether caused by the negligence or carelessness of the STEAM FIELD TRIP/CAMPS AND SPONSORS or otherwise. It is my express intent that this Acknowledgement of Risk and Waiver of Liability shall bind my spouse, the members of my family and my estate, heirs, administrators, personal representatives, and assigns. I further agree to save and hold harmless, indemnify, and defend the STEAM FIELD TRIPS/CAMPS AND SPONSORS from any claim by the aforementioned parties arising out of my participation in the STEAM FIELD TRIP/CAMP. I recognize and acknowledge that the STEAM FILD TRIP/CAMP AND SPONSORS makes no guarantees, warranties, representations, or other promises relative to the STEAM FIELD TRIP/CAMP and assumes no liability or responsibility for injury or property damage that I may sustain as a result of participation in the STEAM FIELD TRIP/CAMP. I further understand and agree that this is a release of liability and indemnity agreement, and it is intended to be as broad and inclusive as permitted by law. If any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and legal effect. I hereby certify that, with or without accommodation, * I have no health-related reasons or problems that preclude or restrict my participation in the STEAM FIELD TRIP/CAMP. I hereby consent to and understand myself to be solely responsible for the cost of first aid, emergency medical care, and, if necessary, admission to an accredited hospital for executing such care or treatment for injuries that I may sustain while participating in any activity associated with the STEAM FIELD TRIP/CAMP. I hereby grant the SAGE CENTER permission to use photographs in any print advertisements, web-based publications, and organization bulletin. I hereby affirm that such release to the SAGE CENTER does not constitute any form of compensation, including royalties arising from the photographs to my benefit. I understand and agree that photographs in the possession of the SAGE CENTER shall become the property of the SAGE CENTER. The use and publication of the photographs, however, shall conform to my rights as a subject of said photographs. I hereby waive my right to inspect of approve the photographs by which my likeness appears. I hereby hold harmless, release, and forever discharge from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.  *If your participation requires an accommodation, please contact at least one week (7 days) before the date of the STEAM FIELD TRIP/CAMP: Brooke Kaschmitter, Port of Morrow STEAM Education Advisor 541-481-7243. In signing this Acknowledgement of Risk and Waiver of Liability I hereby acknowledge and represent: (a) that I have read this document in its entirety, understand it, and sign it voluntarily; and (b) that this Acknowledgement of Risk and Waiver of Liability is the entire agreement between the parties hereto and its terms are contractual and not a mere recital. REQUIRED FOR ALL PARTICIPANTS UNDER 18 YEARS OF AGE: PARENT OR GUARDIAN’S AUTHORIZATION FOR MEDICAL CARE AND CONSENT TO AGREEMENTI certify that I am the parent or legal guardian of the above-named participant in the STEAM FIELD TRIP/CAMP. On behalf of myself and my spouse, partner, co-guardian, or any other person who claims the participant as a dependent, I have read the above agreement, I understand the contents of this Acknowledgement of Risk and Waiver of Liability, assent to its terms and conditions, and sign this Acknowledgement of Risk and Waiver of Liability of my own free act. I acknowledge that my dependent and I have agreed to the terms and conditions of my dependent's participation in the STEAM FIELD TRIP/CAMP, and I hereby give my consent to participation by my dependent in the STEAM FIELD TRIP/CAMP, and to receive medical treatment determined to be necessary. I further agree to hold harmless, indemnify and defend the STEAM FIELD TRIP/CAMP AND SPONSORS from and against all claims, demands or suits that my dependent has or may have.