GENERAL RELEASE OF LIABILITY

By electronically typing my name below, I agree that I have carefully read and acknowledged all of the sections/statements in this form. I further agree to hold harmless and indemnify Fernwood Inc. its employees, agents, officers, representatives, and volunteers, on behalf of myself and my child from any liability arising from any claim of or liability to my child arising from their participation in any activities or treatment at or while present at Fernwood Summer Camps, or while in the care, custody, supervision or control of Fernwood Inc. I understand that by completing and submitting this form via electronic transmission that I acknowledge the above statements and my submission of this form online shall substitute for and have the same legal effect as an original form signature. I understand that this form may be printed out and/or photocopied for direct access by camp staff.