Waiver and Release Form for the ESTe²M Builders Afterschool Program
1) Liability Release
a) In consideration of the acceptance of my application for the ESTe²M Builders program, I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to me as a result of participation in said event. This release is intended to discharge in advance ESTe²M Builders, 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.
b) 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. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees.
2) Parental Consent
By signing this agreement, I give consent for the child that I am registering to participate in the all program activities, and I execute the above liability release on their behalf.
3) Consent for Treatment
a) 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.
b) It is understood that ESTe²M Builders will provide no medical insurance for such treatment, and that the cost thereof will be at my expense.
4) Photo Release for Minor Children
a) I hereby authorize ESTe²M Builders to publish the photographs taken of me and/or the undersigned minor children, and our names, for use in the ESTe²M Builders website and for display in the facility. I release ESTe²M Builders from any expectation of confidentiality for the undersigned minor children and myself and attest that I am the parent or legal guardian of the children listed below and that I have the authority to authorize ESTe²M Builders to use their photographs and names.
b) I acknowledge that since participation in publications and websites produced by ESTe²M Builders is voluntary, neither the minor children nor I will receive financial compensation. I further agree that participation in any publication and website produced by ESTe²M Builders confers no rights of ownership whatsoever. I release ESTe²M Builders , its contractors and its employees from liability for any claims by me or any third party in connection with my participation or the participation of the undersigned minor children.
I have read and understood the foregoing registration liability release and parental consent
form, and agree to all of its terms and conditions.
