PERSONAL RELEASE LIABILITY AGREEMENT
The undersigned acknowledges that this
activity is a potentially dangerous activity involving
RISK OF PERSONAL INJURY, DEATH
AND PROPERTY DAMAGE. I
expressly understand and agree that neither the Town of Oak Creek, CO, a
municipal corporation, nor any of their officers, agents, volunteers,
assistants, or employees shall be held responsible or made the subject of any
claim seeking to assess damages or
liability for or arising from personal injury or property damage or loss of
any other sort to myself or other person in whose
behalf this form is now signed
as a result of actual or proposed participation in the above named program and
I hereby agree to indemnify and hold the Town of Oak Creek, their officers,
agents, volunteers, assistants, or employees harmless on account of any such
claim.
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I give permission for my child/charge (“child”) or children and/or
myself to be transported in a motor vehicle driven by staff or volunteers of
The Two of Oak Creek’s School aged child care program, and The Town of Oak
Creek (TOC).
I understand that all applicable laws regarding riding in a
motor vehicle and directions provided by the driver and/or other adult
volunteers must be followed.
I have read and understand that:
1.I and/or my children will be traveling in a motor vehicle
driven by an TOC staff or volunteer and we are to wear our safety belts (or be
buckled into a car seat); while traveling.
2.We are expected to respect each other, the vehicles we ride
in, and the people we travel with during the trip;
3.We are to remain in our seats and not be disruptive to the
driver of the vehicle.
4.Riding in a motor vehicle may result in personal injuries or
death from wrecks, collisions or acts by riders, other drivers, or objects; and
5.We are not required to participate in TOC programming, but
grant permission, despite the possible risks.
6.I recognize that by participating in this activity, as with
any activity involving motor vehicle transportation, we may risk personal
injury or permanent loss.
I hereby attest and verify that I have been advised of the
potential risks, that I have full knowledge of the risks involved in this
activity, and that I assume any expenses that may be incurred in the event of
an accident, illness, or other incapacity, regardless of whether I have
authorized such expenses.
I hereby give permission for my child(ren)or myself to go on all
scheduled trips AWAY FROM THE PREMISES of the program, in the company of a
qualified adult, whether on foot or by vehicle, using Oak Creek Parks & Recreation
provided transportation when needed. I also give my permission for my
child(ren)or self to be transported by a staff member in a licensed
vehicle in the case of an emergency.
