Tai Chi Registration Form
Tai Chi Participant Registration Form
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Registration Date *
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Class Date *
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Full Name: *
Email Address: *
Age *
Cell Phone Number: *
Zip Code *
Emergency Contact Full Name: *
Emergency Contact Phone Number: *
How did you hear about this program? *
Shelby Farms Park Conservancy General Waiver, Release, and Indemnity
PLEASE REVIEW


I understand that as a user of Shelby Farms Park and/or participant in activities conducted at Shelby Farms Park or sponsored by Shelby Farms Park Conservancy (“SFPC”), I may be exposed to a variety of hazards and risks, foreseen and unforeseen.  These inherent risks may result in injuries, damages and/or death, which can occur by natural causes or activities of other persons, animals or third parties, either as a result of negligence or because of other reasons.

In consideration for being allowed to participate in activities at Shelby Farms Park, including, without limitation, riding bicycles, running on and off trails, riding horses, operating equipment or participating in any other activity at or affiliated with Shelby Farms Park whether or not sponsored by SFPC, I hereby agree and understand as follows:

On behalf of myself, my heirs and my personal representatives, I hereby forever release and discharge SFPC, it directors, officers, employees, agents, volunteers and affiliates (the “Released Parties”), from any and all liability arising out of my use of Shelby Farms Park and/or participation in any activities, including, without limitation, any of the activities listed above, conducted at Shelby Farms Park and/or sponsored by or affiliated with SFPC, including, without limitation, liability for any claims or causes of action whatsoever arising out of any damage, loss, or injury (including death), to me or to property owned by or in the custody of me while engaged in such activities.

I further agree to assume the liability for, and to indemnify and defend SFPC from, any and all claims or damages for any sickness, personal injury, death, property damage or any other loss that may arise, either wholly or in part, out of any negligent, intentional or other act or omission by me in connection with any activities conducted at or engaged in by me at Shelby Farms Park and/or sponsored by or affiliated with SFPC, including those claims or damages that may arise out of the joint or concurrent negligence of a third party, the Released Parties, or any of them or which relate to a condition of the property of Shelby Farms Park or adjacent property.

I consent to whatever medical care might be provided or available at Shelby Farms Park and to conform to and comply with all the rules and regulations of Shelby Farms Park and SFPC.

This agreement is intended to be as broad and inclusive as is permitted by law.  If any provision or any part of any provision of this agreement is held to be invalid or legally unenforceable for any reason, the remainder of the agreement shall not be affected thereby and shall remain valid and fully enforceable.

I have read this agreement in its entirety and I freely and voluntarily assume all risk of any and all activities in which I may engage or in which may be conducted at or affiliated with Shelby Farms Park and notwithstanding such risks, I agree to use Shelby Farms Park and participate in activities conducted at or affiliated with Shelby Farm Park.


NOTICE OF FILMING + PHOTOGRAPHY
When you visit Shelby Farms Park and Shelby Farms Greenline, you are entering an area where photography, audio, and video recording may occur. By agreeing to these terms, you consent to your image and likeness captured via photography, audio recording, video recording and its release, publication, exhibition, or reproduction to be used for promotional purposes, advertising, inclusion on websites, social media, or any other purpose by Shelby Farms Park Conservancy and its representatives. You release the Shelby Farms Park Conservancy, its employees, and each and all persons involved from any liability connected with the taking, recording, digitizing, or publication and use of interviews, photographs, computer images, video and/or or audio recordings, and you waive all rights to any claims for payment or royalties in connection with any use of these materials. You also waive any right to inspect or approve any photo, video, or audio recording taken by Shelby Farms Park Conservancy or the person or entity designated to do so.

I have read and agree to the above terms. *
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