In consideration of my minor child being permitted to participate in the Developing Despite Distance (3D) Youth Development program, I agree to indemnify and hold harmless 3D and its directors, officers, employees, agents, volunteers, participants, and all other person or entities acting for them (hereinafter collectively referred to as "Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.

1. I hereby consent to the above person participating as a Program Participant in 3D. I recognize that participating in 3D activities involves known and unanticipated risks which could result in physical or emotional injury, permanent disability, death, and property damage. I understand such risk cannot be eliminated without jeopardizing the essential qualities of the activities.

2. l understand that it is the express intent of 3D programs to provide for the safety and protection of my child and, inconsideration for allowing my child to participate in 3D programs, I hereby forever release 3D, its officers,employees, and volunteers, from all liability for any and all damages and injuries suffered by my child while under the supervision, instruction, or control of 3D. As legal guardian of the aforementioned person or any member of my family, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of any injury sustained while participating in 3D programs.

3. This acknowledgement of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily to its content and intent. I promise not to sue.

4. I hereby give permission to trained medical professionals to administer emergency medical treatment to my child should sickness or accident occur in my absence.

5. I expressly agree that this Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Michigan and shall be governed by and interpreted in accordance with the laws of the State of Michigan. In the event that one or more clauses of this Agreement is found to be unreasonable, unenforceable, or illegal by a court of competent jurisdiction, I agree that the Agreement will remain in full force and effect except for the unreasonable, unenforceable, or illegal provision; the remaining portions shall remain in full force and effect.

I have read, understand, and agree with the policies and liabilities on this form, and should I choose to do so, consult with legal counsel prior to signing. I understand that this activity might not be made available to me if I were to choose not to sign this Agreement.

By typing my name in the "Signature" field below, I am signing this Agreement electronically. I agree my electronic signature is the legal equivalent of my manual signature on this Agreement. By typing my name in the "Signature" field below, I consent to be legally bound by this Agreement's terms and conditions.