WAIVER and RELEASE OF LIABILITY for Beacons, Inc.
All persons must submit a COMPLETED and SIGNED "WAIVER and RELEASE of LIABILITY" to Beacons, Inc. in order for the participant listed below to attend a Beacons, Inc. activity or program.

TO PRINT TO SIGN: After completing and submitting this form, a copy will be automatically sent to the email address provided below. You may print a copy of this WAIVER and RELEASE of LIABILITY from the email sent to you for purposes of signing it to submit to Beacons, Inc.

This WAIVER and RELEASE of LIABILITY is entered into on the date below by and between Beacons, Inc., its Board members, administrators, instructors, staff, and volunteers (referred to collectively herein as "Beacons"), and the undersigned, or legal guardian/conservator of conserved participant, wishing to participate in activities, programs, services and opportunities (collectively referred to as "Options) provided by Beacons.

This form shall remain in effect for one year from the date it was signed unless revoked in writing by the signing party.

As additional consideration for Beacons to provide Options to the participants, I, for myself and for my conserved adult child(ren), heirs, executors, administrators, successors and assigns, release, acquit and forever discharge Beacons, its Board members, instructors, staff, volunteers, landlord and owner of the event location, from any and all claims, actions, causes of action, demands, rights, damages, costs, loss of services, expenses and compensation whatsoever, whether known and/or unknown, foreseen or unforeseen, anticipated or unanticipated, which we may have or which may hereafter accrue on account of or in any way growing out of our use of Beacons and its facilities on this or any other date.

It is further understood and agreed that all rights under Section 1542 of the Civil Code of the State of California and any similar law of any state or territory of the United States are hereby EXPRESSLY WAIVED.  Said section reads as follows:

Cal. Civ. Code Section 1542 - Certain claims not affected by general release.
A general release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him must have materially affected creditor's settlement with the debtor.

I DECLARE THAT THIS AGREEMENT CONTAINS THE ENTIRE AGREEMENT BETWEEN THE PARTIES AND THAT THE TERMS ARE CONTRACTUAL AND NOT MERELY RECITALS. I AM OF LEGAL AGE AND CAPACITY AND WILLINGLY ENTER INTO THIS AGREEMENT AND AGREE TO BE BOUND BY THEM.

IF ANY PROVISION IS FOUND TO BE INVALID OR UNENFORCEABLE, the remainder will remain valid and enforceable. Any disputes hereunder will be interpreted in accordance with California law with venue in San Diego County.

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Email *
Name of Participant: *
Age of Participant: *
Name of person completing Waiver and Release of Liability: *
Date: *
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Cell Phone Number of person completing this form: *
Is the intended participant conserved? *
Name of Conserved Person (if participant is conserved)
Emergency Contact # *
Participant’s Street Address: *
City, State and Zip *
Participant's Home Phone Number: *
I understand and agree to the terms of this WAIVER and RELEASE OF LIABILITY. *
SIGNATURE - PLEASE PRINT  & BRING IN FORM WITH YOUR SIGNATURE  (Thank you!)
SIGNATURE: _________________________________________________________________________
BEACONS REVIEWER: Please check the form and make sure the form is signed. If form is completed, please complete the review process by adding your initials below. Thank you!
INITIALS: ____________________________________________________________________________
A copy of your responses will be emailed to the address you provided.
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