IN CONSIDERATION OF the participant(s), me and/or my minor child/ward (“my child”), being allowed to participate in any way in the Town of Summerville Parks & Recreation program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
I/we hereby grant consent to any and all Health Care Providers designated by the Town of Summerville Parks & Recreation Department to provide me or my child any necessary care as result of any injury/illness. This consent includes First aid and transportation to/from Health Care Providers by Emergency Services.
IN CONSIDERATION OF the participant(s), me or my minor child/ward (“my child”), I understand and agree that by being allowed to participate in the Town of Summerville Parks & Recreation Department program, related events, and activities, that my child’s likeness may be photographed and/or videotaped and that such image(s) may be published in an outlet used to promote or publicize the program.
This field is not part of the form submission.
* indicates a required field