Waiver – Participation, Transportation, Personal Hygiene & Appropriate Clothing 2024
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メールアドレス *
NAME *
THIS ACTIVITY WAIVER FORM (this "Waiver") dated this *
YYYY
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MM
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DD
IN CONSIDERATION of being allowed to participate in the  full range of programs and
activities (the “Activity”) and other good and valuable consideration, the receipt of which is hereby acknowledged, we/I,(Name of Parent/Guardian,)
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agree on behalf and with: (Name of Participant)
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1. Services. The Client and the Participant hereby authorizes and consents for the Participant, to
participate in the Activity provided by the Activity Provider  ZACHARY'S CAMP for the 2023 program year.
In consideration of the Activity Provider making the Activity available to the Participant, the Client
and the Participant hereby releases and forever discharges the Activity Provider and their
representatives, staff, contracted individuals as well as employees, officers, directors, agents,
servants and officials from any and all actions, costs, expenses, causes of actions, claims and
demands for damages, loss, injury or death howsoever caused, arising out of or in connection with
the Participant's participation in the Activity which heretofore may have been or may hereafter be
sustained by the Participant in consequence of participating in the Activity provided by the Activity
Provider not withstanding that the same may have been contributed to or occasioned by the
negligence the Activity Provider and their representatives, staff, contracted individuals as well as
employees, officer, directors, agents, servants and officials  (Name of Parent/Guardian)
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2.Transportation. The Client and the Participant consent to the Participant travelling, as part of the
Activity of the Activity Provider, by bus or other public transportation or any other transportation
arranged by the Activity Provider or on foot into the general community in the company of staff
from the Activity Provider.
⮚ For said consideration, the Client and the Participant further agree not to make any
claim or take any proceedings against any other person or corporation who might claim
contribution or indemnity under the provisions of the Negligence Act and the
amendments thereto from the person/persons or corporations discharged by this
release. (Name of Parent/Guardian)
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3.Personal Hygiene. The Client and the Participant, consent and grant permission for the staff and
volunteers of the Activity Provider to assist the Participant with personal hygiene, toileting and/or
dressing (i.e. swimsuit to clothing) for the 2023 program year. (Name of Parent/Guardian,)
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4. Appropriate Clothing. Heat illness can lead to long-term health problems and even death. These
illnesses include heat stroke, heat exhaustion, heat fainting, heat edema, heat rash and heat cramps.
Especially during physical activity, your body produces heat. This heat is lost by contact with cool
air and by sweat production which cools your body as it evaporates. When exposed to cold
temperatures, your body begins to lose heat faster than it can be produced. Prolonged exposure to
cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally
low body temperature. A body temperature that is too low affects the brain, making the victim
unable to think clearly or move well.
Therefore, for the health and safety of the participant, the Participant is required to wear
appropriate clothing for the Activity and environmental conditions. Appropriate clothing is
described as:

● Clothing that is comfortable and allows easy movement.
● In cold weather: layered clothing so layers can be removed or added as the body
warms up or cools down (i.e., sweat-wicking T-shirt, sweat shirt, jacket, hat &
mitts/gloves).
● In hot weather or during indoor physical activity: clothing that lets air circulate
and moisture evaporate (i.e., T-shirt & shorts). (Name of Parent/Guardian,)
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5. The Client and the Participant agree to assume full responsibility for any risks, injuries or
damage, known or unknown, to the Participant as a result of the Activity Provider not being
provided with appropriate clothing from the Client and the Participant for the Participant to
wear or as a result of the Participant not wearing appropriate clothing, as set out in Clause 4. (Name of Parent/Guardian,)
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Consideration
6. The Client and the Participant, and in consideration of the Participant being permitted to
participate in the Activity, on behalf of the Participant, the Client and the Participant releases
and forever discharges the Activity Provider, its owners, directors, officers, employees, agents,
assigns, legal representatives, and successors from all manner of actions, causes of action, debts,
accounts, bonds, contracts, claims, and demands for or by reason of any injury to person or
property, including injury resulting in the death of the Participant, which has been or may be
sustained as a consequence of the Participant's participation in the Activity, and not withstanding
that such damage, loss, or injury may have been caused solely or partly by the negligence of the
Activity Provider. (Name of Parent/Guardian,)
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7. The Client and the Participant understand that the Participant would not be permitted to participate
in the Activity unless the Client and the Participant has signed this Waiver.(Name of Parent/Guardian,)
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Concurrent Release
8. The Client and the Participant acknowledges that this Waiver is given with the express intention
of effecting the extinguishment of certain obligations owed to the Participant by the Activity
Provider, and with the intention of binding the Participant's heirs, executors, administrators,
legal representatives, and assigns. (Name of Parent/Guardian,)
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Fitness to Participate
9. The Client and the Participant acknowledges to the Activity Provider that the Participant does
not have any physical limitations, medical ailments, or physical or mental disabilities that would
limit or prevent the Participant from participating in the Activity. If required, the Participant will
obtain a medical examination and clearance.
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10. If the Participant is taking medication, the Client and the Participant are responsible for
contacting the pharmacist to find out if the Participant’s medication increases their health risk
in the heat.
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Full and Final Settlement
11. The Client and the Participant acknowledges and agrees with the Activity Provider that: (1) the
Activity Provider has given the Client and the Participant sufficient time to carefully read this
Waiver, (2) the Client and the Participant have been given the opportunity and has been
encouraged to seek independent legal advice prior to signing this Waiver, (3) the Client and the
Participant fully understands the risks and claims that the Participant is waiving to participate in
the Activity, (4) the Client and the Participant are freely and voluntarily executing this Waiver,
and (5) the Participant is forever prevented from suing or otherwise claiming against the Activity
Provider for any property loss or personal injury that the Participant may sustain while
participating in or preparing for the Activity.
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Governing Law
12. This Waiver will be governed by and construed in accordance with the laws of the Province of
Ontario.
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