Waiver and Release Form for Acton Academy Silicon Valley Enrichment Camp Program
Liability Release and Parental Consent Form
In consideration of the acceptance of my application for the enrichment camp program, I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to my child as a result of their participation in said summer program. This release is intended to discharge in advance the Acton Academy Silicon Valley, its officials, officers, employees, volunteers, and agents from liability, even though that liability may arise out of perceived negligence on the part of persons mentioned above. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. I understand that AASV may, in its sole discretion, dismiss any camp participant for inappropriate, disrespectful, or dangerous behavior at any time. In this event, I understand that I will not receive a refund of camp fees for unattended days. I understand that while participating in this activity, my child may be photographed. I agree to allow their photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. It is further understood and agreed that this waiver, release, and assumption of risk is to be binding on my heirs and assignees.
Consent of the Parent or Guardian
I give consent for my child to participate in this enrichment camp program, and I execute the above liability release on my child’s behalf.
Consent for Treatment
I hereby give my consent to have the above applicant treated by emergency medical personnel, a physician, or surgeon, in case of sudden illness or injury while participating in the above activity. It is understood that Acton Academy Silicon Valley will provide no medical insurance for such treatment, and that the cost thereof will be at my expense.
I have read and understood the foregoing registration liability release and parental consent form, and agree to all of its terms and conditions.
