MCIS PARTICIPANT WAIVER AND RELEASE OF LIABILITY 2021-2022
Each participant is required to sign this waiver form in order to participate in any Medical Center Islamic Society (MCIS) activity for the year 2021-2022. No signed waiver = No participation.
READ BEFORE SIGNING: In consideration of being allowed to participate in any way in MCIS activities, programs, related events and activities, the undersigned acknowledges, appreciates, and agrees that:
Email *
Name of Participant *
Date of Birth *
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Phone No. (Parent) *
Name of Legal Parent or Guardian *
email address *
1. The risk of injury from the activities involved in this program is significant, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist *
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation *
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately *
4. Parents are responsible to take care of their child to and from the MCIS facility after program. *
5. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Medical Center Islamic Society (MCIS) involved in any activity committee planning, their officers, officials, agents, and/or employees, their volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law *
6. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *
Parent/Guardian Signature *
Date *
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