PLEASE READ THIS DOCUMENT CAREFULLY. My child/charge would like to participate with the ENVISION Blind Sports organization. The UNDERSIGNED does hereby acknowledge that my participation as part of the ENVISION Blind Sports organization could expose me to above-normal risks. I understand that the program can be physically demanding. I acknowledge the risks of physical activities, sport activities, equine activities, and horseback riding. However, I feel that the possible benefits to myself/my child/my ward are greater than the risk assumed. I affirm that my/my child’s health is good, and that I/my child/my ward am under a physician’s care for any undisclosed condition that bears upon my fitness or health to participate in any activities presented by ENVISION Blind Sports organization. I understand that each participant must assume the risk of physical injury that could result from any of these activities. I hereby, intending to be legally bound, for myself, my heirs, assigns, executors, and administrators, waive and relinquish and release forever any and all claims for damages against ENVISION Blind Sports, its board of directors, instructors, therapists, staff, aides, volunteers, and employees for any and all injuries and/or losses that I/my child/my ward may sustain while participating in the ENVISION Blind Sports organization. I have read and understand all information provided. I also understand that information from these programs may be released for educational purposes and demonstrations to improve program development and future replication. In the case of an emergency and if I cannot be reached, I authorize the ENVISION Blind Sports staff to obtain whatever medical treatment deemed necessary for the welfare of my child. I further understand and agree that I will be financially responsible for all charges and fees incurred in the rendering of said emergency treatment regardless of whether or not my medical insurance would cover such charges and fees. My child/charge desires to participate in the specified program. I understand the above mentioned program offered through ENVISION Blind Sports will take place, at least partially, in an offsite environment and may include, but not limited to, the following potentially hazardous activities: hiking, tandem biking, swimming, canoeing, paddle boarding, tennis, golfing, goalball, trampoline park, beep baseball, ice hockey, judo, wrestling, horseback riding, initiative activities, high/ low ropes course, rock climbing and vehicular transportation to and from activity sites. The inherent risks of these activities include: personal injury, property damage, illness or death. I understand that the ENVISION Blind Sports organization does not require that I participate in the above-mentioned activities. In recognition of the potentially hazardous nature of the program, I, or my child, my heirs and assigns, hereby release the ENVISION Blind Sports organization and the staff, associates and affiliates of ENVISION Blind Sports from all claims of negligence arising from participation in the activity. I further agree to hold harmless and indemnify the ENVISION Blind Sports organization and the staff, associates and affiliates of ENVISION Blind Sports for all defense costs, including attorney fees and any other costs resulting in connection with my participation in this activity. I understand that this release relates to all claims of liability during and after the trip resulting from a preexisting medical condition. I have read and fully completed the medical form provided by the ENVISION Blind Sports organization and accept full responsibility for omissions or errors on the medical form. I also understand that this release relates to all claims of liability resulting from unforeseen or intemperate weather. I have read this entire acknowledgement, assumption of risk and release of claims” and fully understand the contents. *
