Medical Authorization/Waiver of Liability
I confirm that I am the parent or legal guardian of the above named registrant; I am at least eighteen years of age and have legal authority to give consent to treatment and waiver of liability. I agree to provide The Robert McLaughlin Gallery (RMG) with further evidence of such authority, and/or evidence of the age of any participant or myself upon request, and acknowledge and agree that if I fail to do so to the satisfaction of The Robert McLaughlin Gallery in its sole discretion, the applicant(s) may be denied registration/participation in the pertinent program.
In making this application for registration, I understand that in the event of a medical emergency every reasonable attempt will be made to contact me, or the emergency contact listed on this form. However, in the event that I or my named contact cannot be reached, I give permission to the staff of The RMG to secure emergency medical treatment for my child. I understand that any/all costs related to such actions shall be my responsibility and agree to pay and/or reimburse The RMG for any such costs that may be incurred.
I acknowledge that nothing in this consent form obligates The RMG to provide medical treatment or related services, or to have medically trained personnel available onsite at any time. Therefore I cannot rely on the availability or receipt of any medical treatment or advice from The RMG staff, contract personnel or volunteers for any participant in any program provided by/through The RMG, and I confirm that The RMG has given no representations or warranties to the contrary.
I understand that if my child has an allergy or other medical condition that may require a quick response with medication, either myself or (with written permission) another responsible adult is welcome to stay in the Gallery in the event that my child is in need. If your child requires an Epipen it is your responsibility to ensure the Epipen is kept on the child’s person at all times. RMG staff has up-to-date Basic First Aid training.
I hereby waive any and all claims, actions, damages, costs and expenses arising from the registration or participation by any participant named in this application including myself, in any program operated by The RMG, caused by negligence or otherwise, including but not limited to those claims, actions, damages, costs and expenses arising from personal injury, death, property damage, lost or stolen property or in respect of any act or allegation of negligence, negligent misrepresentation, breach of statutory duty, breach of the Occupier’s Liability Act, or breach of contract by The RMG. Furthermore, I hereby indemnify and save harmless The Robert McLaughlin Gallery in respect of all liability, whether direct or indirect and whether caused by negligence or otherwise, from and against any claims which may be made against The Robert McLaughlin Gallery by any third party arising from the registration or participation of any participant named, including myself, in this registration application in any program operated by The Robert McLaughlin Gallery.
