City of Deltona Event Minor Participation Release

AGREEMENT ASSUMING RISK OF INJURY OR DAMAGE

RELEASE OF LIABILITY AND INDEMNITY AGREEMENT

Child not being over the age of eighteen and not being employed by the City of Deltona, having made a voluntary request to participate in a City of Deltona sponsored event, and I, as natural guardian do hereby:

1. Release, waive, and forever discharge the City of Deltona, its officers, employees and agents from any liability, actions, causes of action, damages, claims, and demands of every kind and nature whatsoever arising out of or resulting from participating in a City sponsored event including but not limited to, riding in or on any City of Deltona vehicle or equipment, or while accompanying any member or members of a City Department/Division during the performance of their official duties, or resulting from any act of omission on the part of any City of Deltona employee.

2. Agree to defend, indemnify, and hold harmless the City of Deltona, its officers, employees, and agents, against any and all manner of actions, causes of actions, suits, debts, claims, demands, or damages or liability or expense of every kind and nature incurred or arising by reason of any actual or claimed negligence or wrongful act or omission of the City of Deltona while participating in a City sponsored event including, but not limited to, riding in or on any City of Deltona vehicle or equipment, or while accompanying any member or members of a City Department/Division during the performance of their official duties.

3. I also waive and release the use of my minor child or ward’s photograph or likeness for any reason or purpose relating to the City of Deltona’s public practices.

NOTICE TO THE MINOR CHILD’S
NATURAL GUARDIAN

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF CITY OF DELTONA USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR

ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM THE CITY OF DELTONA IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND CITY OF DELTONA HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

MEDICAL RELEASE: In the event that I am unable to be reached in an emergency, I hereby give permission and accept financial responsibility for medical treatment, and related transportation, to any licensed physician, surgeon, clinic, hospital, or ambulance service to secure proper treatment, and to order anesthesia, for my child as named above. My child is allergic to the following medications: __________________________________________________

This release, waiver and hold harmless agreement shall be binding upon me and my heirs, personal representatives, successors, and assigns.

I hereby represent that I have carefully read and understand the contents of this document and sign the same of my own free will.

The contact will be automatically added to the class as a registrant if someone drops out from a full class.