Release and Wavier of Liability and Indemnity
The Participant and Parent/Legal Guardian agree to release and waive all claims and hereby indemnify and hold harmless Camp KidsTown its volunteers and other participants for any and all liability for any property damage or personal injury resulting from the administration of epinephrine. The Participant and Parent/Legal Guardian hereby further agree that Camp KidsTown, its volunteers and other participants shall not be liable, either directly
or indirectly, for any claims, or any damages, costs and expenses respecting any act done in good faith, including, but not limited to personal injury, death, property damage or loss in the administration of epinephrine, whether or not such injury, damage or loss occurred as a result of any negligence, negligent misrepresentation or breach of statutory duty and/or breach of contract on the part of Camp KidsTown, its volunteers and other participants, unless damages are the result of gross negligence on the part of the City, its volunteers and other participants.
Assumption of Risks
The administration of epinephrine involves various risks, dangers and hazards which the Participant is required to assume. The Participant and Parent/Legal
Guardian hereby freely accept and fully assume all such risks, dangers and hazards and the possibility of personal injury, death, property or loss resulting there from.
Consent to Medical Treatment
The participant and Guardian agree to hereby give permission to have Camp KidsTown, its volunteers and other participants arrange for any emergency medical care including hospitalization/transportation, if necessary, to the administration of such emergency medical treatment as may be deemed necessary in the
circumstances. The Participant and Parent/Legal Guardian agrees to pay all costs associated with medical care and transportation.
If the participate is under 18, a Legal Guardian must complete the following:
Or, if under 18 years of age:
