1. I hereby certify that I am, or in the event I am registering my minor child, my child is in normal health and capable of participating in the above listed activity.

2. In the event of injury to my minor child, as a parent or legal guardian, I authorize a licensed physician to examine my child and in the event of injury to render such emergency care as he or she deems necessary for the treatment of such injury, including consultation and treatment by a specialist, including a surgeon. As parent or legal guardian, I authorize WABASSO COMMUNITY EDUCATION to send my minor child to the hospital or doctor most accessible.

3. I am fully aware of the fact that there are special dangers and risks inherent in certain recreational activities. Being fully aware of those risks and in consideration of being allowed to participate in WABASSO COMMUNITY EDUCATION, on behalf of myself and/or my minor child, I hereby assume all risk of injury, damage and liability arising from such activities or use and hereby release WABASSO COMMUNITY EDUCATION , its officials and waive any right of recovery that I might or my minor child may have to bring claim or a lawsuit against them for any personal injury, death or other consequences occurring to me or my minor child arising out of my or my minor child's voluntary participation in WABASSO COMMUNITY EDUCATION.

"PHOTOGRAPH AND VIDEO RELEASE":

Photographs or video may be taken at WABASSO COMMUNITY EDUCATION or other events sponsored by WABASSO COMMUNITY EDUCATION, including photographs of you, your family, and/or your children. Some of these photographs may be used in printed materials and/or on our official website or our sponsored social-media website on the internet to promote future events sponsored by WABASSO COMMUNITY EDUCATION. In the event a photograph or video is used for these purposes, every effort will be made to protect the individual identity of all individuals depicted in the picture or video. No names, telephone numbers, addresses or other identifying information will be placed in the printed materials or on the internet. For these reasons we are asking for your permission to use your/your child's photographs in our materials and on our website. By signing below, I hereby grant WABASSO COMMUNITY EDUCATION permission to use photographs, video and/or other images of my children) for the purposes outlined above."

PRIVACY ADVISORY:

The information you provide, including your name, address, telephone number, and any other identifying information, is classified by state law as private and is not accessible by the public but is accessible by you, or in the case of a minor is accessible by a parent or guardian or an individual acting as a parent or guardian in the absence of a parent or guardian, except that WABASSO COMMUNITY EDUCATION shall withhold data from parents or guardians, or individuals acting as parents or guardians in the absence of parents or guardians, upon request by the minor if WABASSO COMMUNITY EDUCATION determines that withholding the data would be in the best interest of the minor. We need this information to enroll you in the program and to be able to contact you if necessary. If you do not provide the information, you will not be enrolled in the requested program. This information will be provided to the coaches and members of any team that you are on and to recreation personnel who have a need to know it, such as referees.