Acknowledgement of Risk, Waiver, and Release of Liability
Upon completing registration each year, parents are asked to sign the form below. Please direct any questions or comments about this form to email@example.com
I understand and acknowledge that participation in the camps, events, or programs operated or conducted by Steve and Kate's Camp LLC (the "Camp"), including all of its activities and the use of its facilities and equipment, involves an inherent and unavoidable risk of injuries, harm, and loss. I understand that although the Camp takes precautions to provide proper organization, supervision, and equipment, it is impossible for the Camp to guarantee absolute safety. I understand there are numerous risks associated with participating in the Camp’s activities, including, but not limited to, the use of playgrounds, electric Go Karts, inflatable equipment, game room equipment, electronic devices, camp-provided food, as well as participation in sports and active games, sewing and knitting activities, Maker activities/projects, and baking activities. Equipment used in activities may break, fail, or malfunction and cause injury. Some of the equipment used in activities may cause injuries even when used as intended. These are some, but not all, of the risks inherent in Camp activities; a complete listing of inherent risks is not possible and some risks cannot be anticipated.
I authorize the child/children named in this registration to participate in the camps and all activities operated by the Camp, both on and off site. On my own behalf and on behalf of the child/children named in this registration, I ACKNOWLEDGE THE RISKS associated with participation in the Camp and expressly and voluntarily assume the risks of participation in the camps and activities operated by the Camp and HEREBY WAIVE AND RELEASE ALL CLAIMS, DEMANDS, ACTIONS, CAUSES OF ACTION, COSTS, LOSSES, EXPENSES AND LIABILITIES (“CLAIMS”) (WHETHER ON BEHALF OF THE CHILD/CHILDREN NAMED IN THIS REGISTRATION OR FOR MY OWN BENEFIT) AGAINST THE CAMP (INCLUDING ITS STAFF, EMPLOYEES, AND AGENTS) THAT MAY ARISE FROM INJURIES, HARM OR LOSS RESULTING FROM PARTICIPATION IN THE CAMPS AND ACTIVITIES OPERATED BY THE CAMP, INCLUDING (WITHOUT LIMITATION) ANY CLAIMS ALLEGING NEGLIGENCE BY THE CAMP (INCLUDING ITS STAFF, EMPLOYEES, AND AGENTS), to the fullest extent allowed under the laws of California, Colorado, District of Columbia, Georgia, Illinois, Massachusetts, New Jersey, New York, Oregon, Pennsylvania, Virginia, and Washington (as applicable based on the location of the camp, program, or event where your child/children attend or participate). If any aspect of this waiver is deemed to be invalid, I acknowledge that the remainder of the agreement will continue to have full force and effect. If my agreement on behalf of my child/children to release their Claims against the Camp is deemed invalid for any reason, I agree to indemnify, defend and hold the Camp harmless in connection with any Claims arising out of my child's/children's participation in the camps, programs, events and activities operated by the Camp, including payment of reasonable defense costs incurred by the Camp.
I hereby authorize the staff of the Camp to act according to their best judgment in any situation requiring medical attention for the child/children named in this registration. I understand that it is my responsibility to provide medical insurance coverage for the child/children named in this registration while they are attending camps operated by the Camp and to provide accurate and complete medical information. I attest that all immunizations for the child/children named in this registration that are required by their school or local school district are up to date, OR I am refusing this requirement for religious or other reasons. (Please Note: In some states there are additional requirements related to camper medical history and supporting documentation.)I acknowledge that the costs of any medical treatment provided to the child/children named in this registration that are not covered by medical insurance will be my sole responsibility, consistent with the waiver of Claims above.
The Camp reserves the right to expel or to deny re-enrollment or participation of child/children if, in the Camp’s sole and absolute discretion, (i) the actions of a child/children or their parent/guardian disrupt, impede or interfere with the Camp’s ability to maintain a positive and constructive relationship with all participants and their parents/guardians (including but not limited to non-payment of Camp fees), (ii) such actions threaten the safety of the child/children, other children, or Camp staff, (iii) such actions otherwise interfere with the Camp’s accomplishment of its mission, or (iv) if expulsion or refusal to re-enroll would be in the best interest of the camper or the Camp. The Camp will make every attempt to communicate with the child/children and their parent/guardian regarding any actions that would put a child/children at risk of expulsion or denial of re-enrollment. If, in its sole and absolute discretion, the Camp decides to expel or refuse enrollment or participation to a child/children, any fees paid for unused days, if applicable, would be refunded.
As to any child/children who are enrolled in a camp operated by the Camp, I agree that the Camp (including its staff, employees and agents) can take and use photos, video and audio recordings of the child/children named in this registration for the limited purposes of marketing the Camp which may be publicly available on the internet, without compensational obligation, and I hereby release the Camp (including its staff, employees and agents) from any Claims resulting from their use of photos, videos and audio recordings (Please note: if you want to understand why we seek your consent for this or to request that we do not publicly use photos, videos and/or audio recordings featuring your child/children, please contact firstname.lastname@example.org). I agree to receive periodic email, phone or written communication from the Camp regarding products, services or information that may be of interest to me.
Further, I acknowledge and agree that child/children and myself and any co-parent or co-guardian, are not allowed to take, and shall not take, any photographs, video, or other recordings of other children or other parents/guardians participating in camps, events, or programs without their express consent, and are not allowed to transmit, upload, or post such content online or electronically including on any social media or similar site, or use or publish such content in any non-personal media such as a book, video, film, television program or publicly viewable website. Upon the Camp’s request, I agree to delete and/or remove such content from any device, site, platform, or other media, if, in the Camp’s sole and absolute discretion, such content and/or the manner in which it is presented violates the terms of this agreement, is objectionable, inappropriate, or violates the privacy rights or right of publicity of others.
As to any child/children who are enrolled in a camp operated by the Camp, I hereby authorize the Camp to withdraw from my bank account or charge my credit/debit card the full cost of the camp day(s) and/or membership(s) I have elected to purchase at this time. In the event that there are insufficient funds in my bank account or my credit card is declined at the time of processing, I authorize the Camp to reattempt to process my payment method again until those funds are successfully collected, and I agree to provide an alternate payment method as required by the Camp.
Last updated: May 2, 2019