To acknowledge this waiver, a digital signature is required. You can digitally sign by typing your full name below.
I, the undersigned, release the Patchogue Arts Council, the Patchogue Arts Council Photographers Group located at 20 Terry Street, Patchogue, NY 11772 and all directors of the above from liability associated with any field trip organized by the above, including accidental injury, physical suffering, disability or accidental death. I do not suffer from any medical or health condition that may cause injury to myself, others, or may require emergency care during my participation. I willingly agree to comply with terms and conditions for participation. If 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. 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, and sign it freely and voluntarily without any inducement. This Waiver remains in force for all future field trips organized by the Patchogue Arts Council Photographers Group.
(If under 18 years of age, please fill out next field.)