WaiverAll minors are required to have a waiver on file to participate in any activity at Prince Edward County Food Hub.(* Indicates a Required Field) Open Form Minor Waiver Parent/Guardian Name * First Name Last Name Email * Parent/Guardian Phone Number * (###) ### #### Participant Name * First Name Last Name Date of birth * MM DD YYYY * ASSUMPTION OF RISK RELEASE AND WAIVER OF LIABILITY INDEMNITY AGREEMENT IN CONSIDERATION of allowing my minor child/ward, (as mentioned above), to participate in the program, related events, and activities of Prince Edward County Food Hub (herein after known as the “program”) I WARRANT TO YOU THAT: 1. I am a parent/guardian having full legal responsibility for decisions regarding my minor child/ward, and 2. I understand that while participating in this program, my minor child/ward may be photographed and I agree to allow any and all video, photo, or film likeness to be used for any legitimate purpose by the program and its organizers, and 3. I am familiar with the risk of serious injury and death, which any participant in this program must assume, and 4. I believe that my minor child/ward is physically, emotionally, and mentally able to participate in this program, and that his/her equipment is mechanically fit for his/her use in this program, and 5. I understand and will instruct my minor child/ward that all applicable rules for participation must be followed and that at all times, the sole responsibility for personal safety remains with my minor child/ward, and 6. I will immediately remove my minor child/ward from participation and notify the nearest official if, at any time, I sense or observe any unusual hazard or unsafe condition or if I feel that my minor child/ward has experienced any deterioration in his/her physical, emotional, or mental fitness for continued participation in the program. I UNDERSTAND AND AGREE, ON BEHALF OF MY MINOR CHILD/WARD, MYSELF, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES, AND NEXT OF KIN THAT MY EXECUTION OF THIS DOCUMENT CONSTITUTES: 1. an unqualified ASSUMPTION OF ALL RISKS associated with participation in this program by my minor child/ward, even if arising from negligence or gross negligence, including any compounding or aggravation of injuries caused by negligent rescue operations or procedures of the program organizer and any persons associated therewith or participating therein, and 2. to consent to the provision of medical treatment upon my minor child/ward should such treatment be deemed advisable in the event of injury, accident, and/or illness. Medical treatment shall be considered to include, but not be limited to, standard first aid, the inclusion of emergency providers related to 911 procedures and services, and the permission to transfer said minor child/ward to a hospital should further emergency services be required and I am not available, and 3. a FULL AND FINAL RELEASE AND WAIVER OF LIABILITY of the program, its organizer(s), and all persons and organizations associated with it, including, without limiting the generality of the foregoing, its officers, directors, officials, agents, and/or employees, other participants, sponsors, advertisers, owners, and/or lessors of the premises used to conduct the program, sanctioning bodies, medical or rescue personnel (the RELEASEES), of and from with the respect to all injury, disability, death, or loss, or damage to person or property, whether arising from the negligence or negligent rescue of or by the foregoing or otherwise, and 4. an UNDERSTANDING NOT TO SUE the RELEASEES for any loss, injury, costs, or damages of any form or type, howsoever caused or arising, and whether directly or indirectly from the participation of my minor child/ward in the program, and 5. an AGREEMENT TO INDEMNIFY and to SAVE and HOLD HARMLESS the RELEASEES and each of them from any litigation expense, legal fees, liability, damage, award, or cost of any form or type whatsoever that may incur due to any claim made against them or any one of them, whether the claim is based on the negligence or the gross negligence of the RELEASEES or otherwise. I HAVE READ THIS DOCUMENT THOROUGHLY. I understand that the releasees are relying upon my warranties, assumptions, waiver, and release undertaking and agreements when accepting my minor child/ward’s participation in this program. I understand that by signing this document I give up substantial legal rights and I and/or my minor child/ward would otherwise have. I understand and agree that this waiver and release shall be construed broadly to provide a release and waiver to the maximum extent permissible under the law. I HAVE READ THE ABOVE STATEMENT AND I SIGN THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT. Yes Signature * By typing your name below, you are signing this waiver electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this waiver. Thank you!