Natural Play Project: 10/15/2019 Playdate

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Welcome to the Natural Play Project! Thank you for being here. Please include the names and ages of each child attending with you. Thank you so much, we look forward to seeing you!

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電子郵件 *

Parent Name *

Parent Phone Number *

List all children attending and their ages here | Example: John Smith, 3 years old, Jane Smith, 2 years old. *

List all allergies and medications of attendees that we should be aware of, including yourself. *

Emergency Contact Name *

Emergency Contact Phone Number *

By checking each box you are agreeing to abide by the visitor policies: *

- Minors must be supervised by their accompanying parent/legal guardian at all times.

- Cigarettes, illegal drugs, weapons, and firearms are prohibited.

- All participants are expected to follow safety rules, expectations, and boundaries provided by the Natural Play Project staff

- Please limit cell phone use. In the spirit of full engagement with your children and the natural world, we ask that mobile phones be turned off or set to vibrate.

- Families are responsible for dressing appropriately for the weather and bringing water bottles and snacks as needed.

必填

By checking the box below you are agreeing to the liability waiver. *

I acknowledge that the Participants' participation in NPP/MSCS programs entails known and unanticipated risks that could result in physical or emotional injury, mental stress, permanent disability, paralysis, death, or damage to the Participant, or any one of them, or to third parties. I understand that such risks cannot be eliminated without jeopardizing the essential qualities of these activities.

The risks may include, but are not limited to: Strenuous physical activity; slipping and falling; pinches, scrapes, twists and jolts; sprains, strains, broken bones, collision with fixed or moveable objects; falling objects; water hazards including hypothermia and drowning; exhaustion; weather conditions and exposure to temperature and weather extremes; and exposure to potentially dangerous wild animals, insect bites and stings, and hazardous plant life; burns from open fires; rope burns; injury from tools or using items as tools; equipment failure; improper lifting or carrying, each of the Participants' own physical condition, and the physical exertion associated with this activity; exposure to known and unknown allergens; the conditions of the roads, terrain, and environment in which events take place; other participants’ and/or the Participants' own negligence, together or individually; and emotional stress.

Waiver of Negligence: In consideration of participation in NPP/MSCS events I acknowledge and agree that I am solely and personally responsible for each of the Participants' preparedness, health, well-being, choices, actions and results at all times. I expressly accept and assume all of the risks inherent in this activity or that may be caused by the negligence of NPP/MSCS, during this or any subsequent participation. Each of the Participants' participation in this activity is purely voluntary and I elect to participate despite the risks. If at any time I believe that conditions are unsafe or that the Participants, or any one of them, is unable to participate due to physical or medical conditions, I will immediately discontinue participation.

Indemnity: I hereby voluntarily release, forever discharge, and agree to indemnify, reimburse, and hold harmless NPP/MSCS from any and all claims, demands, or causes of action made by the Participants, individually or together; a parent/guardian of any minor at a NPP/MSCS event; other participants at a NPP/MSCS event; rescuers; and all others, which claims, demands or causes of action are in any way connected with and/or arising out of any or all of the Participants' participation in NPP/MSCS events, during this or any subsequent participation. Should NPP/MSCS or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such attorney's fees and costs.

I certify that I have adequate insurance to cover any injury or damage any or all the Participants may suffer or cause while participating in NPP/MSCS events, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition that the Participants may have.

If the Participants, or any one of them, become injured or ill while participating in NPP/MSCS events, I hereby grant permission for MSCS staff to render first aid and seek emergency medical assistance as they see fit, at my cost. I agree to hold NPP/MSCS harmless for any injury or damage any or all of the Participants may suffer due to the application of treatment, medical services, or emergency medical care provided or offered.

I covenant not to sue NPP/MCSC in the event of injury or loss arising out of any or all of the Participants' participation in NPP/MSCS events, during this or any subsequent participation. In the event that I file a lawsuit against NPP/MSCS, I agree to do so solely in Transylvania County, NC, and I further agree that the substantive law of that state shall apply. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. By signing this document, whether electronically or on paper, I acknowledge that if anyone is hurt or property is damaged during any or all of the Participants' participation in NPP/MSCS events, I may be found by a court of law to have waived my rights to maintain a lawsuit against NPP/MCSC on the basis of any claim from which I have released them herein. By signing this document I release NPP/MSCS from all liability as stated above for all NPP/MSCS events in which I/my children/the children in my care may participate.

必填

Media Release *

I GRANT NPP/MSCS the right to use, reproduce, and/or distribute photographs, films, videotapes, and sound recordings of me/my children/the children in my care for use in materials they may create, including but not limited to social media postings, posters and flyers, and education materials. I also understand that NPP/MSCS is not responsible or liable in any way for photos that other participants post on social media or otherwise share or distribute as they have no control over others' actions.

I DO NOT GRANT NPP/MSCS the right to use, reproduce, and/or distribute photographs, films, videotapes, and sound recordings of me/my children/the children in my care for use in materials they may create, including but not limited to social media postings, posters and flyers, and education materials. I also understand that NPP/MSCS is not responsible or liable in any way for photos that other participants post on social media or otherwise share or distribute as they have no control over others' actions.

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