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Release, Waiver & Consent Form Parent/Guardian
Agreement, Release, and Assumption of Risk |
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Tree Frog Treks offers a wonderful experience to its participants, and
teaches them a great deal about themselves and the world around them. Part of
the magic of Tree Frog Treks is that many activities take place in the outdoors
and all students are invited to actively participate. Obviously, with these
activities comes some risk. Our purpose in this disclosure is not to worry you,
but to point out that there are risks connected with the fun, excitement, and
adventure of a Tree Frog Treks experience. |
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*Important – This Box Must Be Completed for Your Child to
Participate in TFT Programs!* |
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I, the
undersigned, as a parent/legal guardian of the named child, in consideration
of the services of Tree Frog Treks LLC, their agents, owners, participants,
employees, and all other persons or entities acting in any capacity on their
behalf (herein after collectively referred to as "TFT"), hereby
agree to release, indemnify, and discharge TFT, on behalf of myself, my
spouse, my children, my parents, my heirs, assigns, personal representative
and estate as follows: 1.
I
acknowledge that participation in live animal handling, water wading, hiking,
nature exploration, science experiments and art projects, and other outdoor
activities entail known and unanticipated risks that could result in physical
or emotional injury, paralysis, death, or damage to my child, to property, or
to third parties. I understand that such risks simply cannot be eliminated
without jeopardizing the essential qualities of the activities. At any
time, your child is free to withdraw from participation in activities (as
listed above) and their potential for: drowning, slips and falls and falling;
pinches, scrapes, twists and jolts that could result in scratches, bruises,
lacerations, fractures, concussions, or even more severe life threatening
hazards. During an activity there may be contact with plants, animals or
insects that could create hazards such as stings, allergies, and associated
diseases. Furthermore, TFT employees have difficult jobs to perform. They
seek safety, but they are not infallible. They might be unaware of a child's
fitness or abilities. They might misjudge the weather or other environmental
conditions. They may give incomplete warnings or instructions. 2.
I
expressly agree and promise to inform my child of the risks existing in TFT
programs. My child's participation in TFT programs is purely voluntary, and I
elect to allow him/her to participate in spite of the risks. 3.
I
hereby voluntarily release, forever discharge, and agree to indemnify and
hold harmless TFT from any and all claims, demands, or causes of action,
which are in any way connected with my child's participation in summer camp
activities or his/her use of TFT’s equipment or facilities, including any
such claims which allege negligent acts or omissions of TFT. 4.
I
certify that I have adequate insurance to cover any injury or damages my
child may cause or suffer while participating, or else I agree to bear the
costs of such injury or damage myself. I further certify that I am willing to
assume the risk of any medical or physical condition my child may have. 5.
In
the event that I file a lawsuit against TFT, I agree to do so solely in the
state of 6.
I
realize that any photos taken of my child during TFT programs become property
of TFT and may be used in printed literature or marketing materials. I
realize there will be no compensation for the use of said photos. If you do not want your child's photo used in marketing materials,
please check here.
.................................................. o Authorization
for Treatment: I
hereby give permission to TFT staff to provide basic first aid treatment
& care to my child within the scope of their training. I also give
permission to the medical personnel selected by the camp director to order
x-rays, routine tests, and treatment; to release any records necessary for
insurance purposes; and to provide or arrange necessary related
transportation for my child including transportation in private vehicles if
necessary. In the event I cannot be reached in an emergency, I hereby give
permission to the physician selected by the program director to secure and
administer treatment, including hospitalization, for the person named above.
This form may be photocopied for use on off site trips and programs. Participant
Expectations: I
acknowledge that I have read, understand, and discussed with my child the Tree Frog
Treks Expectations. If you do not want your child to be transported via SFMTA, please check
here. ................................................................. o By signing this document, I
acknowledge that I have had sufficient opportunity to read this entire
document. I have read and understood it, agree to be bound by its terms &
consent to my child's participation in Tree Frog Treks activities.
Parent/Guardian's Signature Date
Camper's Printed Name Session(s) |
You
must complete & return this form to Tree Frog Treks at least two (2) weeks
prior to the start of your program!