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Camp Release, Waiver & Consent Form Parent/Guardian
Agreement, Release, and Assumption of Risk |
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Tree Frog Treks Camp 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 summer camp is that the activities take place in the outdoors
and all campers 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 camp experience.
*Important – This Box Must Be Completed for Your Child to
Attend Camp!*
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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 Day Camps, a program 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 camp 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
camps. My child's participation in TFT camps 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 TFTÕs
equipment or facilities, including any such claims which allege negligent
acts or omissions of TFT camps. 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 California, and I
further agree that the substantive law of California shall apply in that
action without regard to the conflict of law rules of that state. I agree
that if any portion of this agreement is found to be void or unenforceable,
the remaining document shall remain in full force and effect. 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 camp 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. Camper
Expectations: I
acknowledge that I have read, understand, and discussed with my child the Tree Frog
Treks Camper Expectations. Field Trip Transportation: I acknowledge that on field trip
days, my child may be transported via San Francisco Municipal Bus,
15-passenger van, or chartered school bus to a field trip destination in or
outside of San Francisco. I consent to my child
being transported via MUNI, van or bus. I understand that if I choose not to
consent to this method of transportation, my child may not participate in
field trip activities unless I arrange for alternative methods of
transportation. If you do not want your child to be transported via SFMTA, van or bus,
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 Day Camp activities.
Parent/Guardian's Signature Date
Camper's Printed Name Session(s) |