CONSENTS, DISCLOSURES AND WAIVERS BY PARENT OR GUARDIAN OF A MINOR
THIS AGREEMENT is made and entered into this date between the parties: ASSYRIAN EVANGELICAL CHURCH OF SAN JOSE a California Nonprofit Corporation, hereinafter referred to simply as “AEC”, and: Parent / Guardians listed in the first section of this waiver form.
Provides as follows:
ACTIVITY: NOVEMBER 03, 10, 17, and 24, 2020 CCYTH NIGHT,
NOVEMBER 08, 15, 22, 29 2020 CCYTH SUNDAY WORSHIP
Full name of Minor Child wishing to participate in said ACTIVITY: listed above in the student section of this waiver.
FIRST: Participant signing below represents that he/she/they are adult natural parent(s) or legal guardian(s) of the Minor Child(ren) named above.
SECOND: ASSYRIAN EVANGELICAL CHURCH- The parties acknowledge that AEC is a California Non-Profit Tax-Exempt Religious Corporation, with principal offices located in San Jose, California, among which are large campus grounds, buildings and other multi-purpose facilities and structures, including athletic fields and parking areas, all of which are distinguishable separate or isolated locations. AEC makes no representation regarding the suitability of the premises for any reason or purpose. Participant has either:
1.) conducted his/her/their own independent examination of the premises, determining for his/her/themselves that said premises are suitable for the purposes contemplated by this agreement; or 2.) waives his/her/their own independent examination of the premises and accepts said premises as suitable for the purposes contemplated by this agreement.
THIRD: OFF-SITE PHYSICAL PREMISES -AEC makes no representation regarding the suitability of any off-site premises for any reason or purposes. Participant has either: 1.) conducted his/her/their own independent examination of the off-site premises, determining for his/her/themselves that said off-site premises are suitable for the purposes contemplated by this agreement; or 2.) waives his/her/their own independent examination of the off-site premises and accepts said off-site premises as suitable for the purposes contemplated by this agreement.
FOURTH: PARTICIPATION DISCLOSURES AND WAIVERS? Participant and AEC
understand and agree that there are a number of various programs undertaken by departments and groups in affiliation with AEC, on and off the AEC campus premises, involving activities and individuals that are often not under direct control or supervision of AEC, and that there is an overriding policy that each participant involved in these programs does so at their own risk of personal injury or damage to property.
Furthermore, Participant and/or the named Minor Child(ren) desires to take part in the ACTIVITY mentioned hereinabove, and fully understands and agrees that such ACTIVITY might involve sporting activities, travel or contacts with other individuals or groups, and that AEC has limited or no control over other individuals involved in such ACTIVITY; and that there is always the risk of physical injury, illness, and other loss, and possible costs or expenses for medical or dental diagnostic and curative treatments, and general and special damages for incidental loss or expense; and Participant does for himself/herself/themselves, and for and on behalf of said Minor Child(ren) and his/her/their family, representatives and heirs, assume the risk of all such injury, loss, expense and damages, to person or property, and does hereby wholly release AEC and its officers, directors, representatives, employees, and its agents from all responsibility or liability, and waives any and all claims or causes of action against AEC and its officers, directors, representatives, employees, and its agents that might arise from or on account of any sort of loss or injury of or to person or property of any description in this regard; and as an inducement to AEC and its agents to allow the Participant and/or such Minor Child(ren) as mentioned hereinabove to participate in such ACTIVITY, does hereby agree to indemnify, defend and hold harmless AEC and its officers, directors, representatives, employees, and it agents from all these things (including without limitation, injuries, losses, damages, claims,
liabilities, costs, expenses, and attorneys’ fees) in event any such claim should arise. It is understood by the parties that this waiver is not meant to, nor does it, release AEC from liabilities for willful misconduct by AEC and its officers, directors, representatives, employees, and its agents.
FIFTH: MEDICAL AUTHORIZATION AEC does not act as an insurer, guardian, guarantor or warrantor of health or safety of anyone involved in such activity. Participant affirmatively represents that said Minor Child(ren) has/have special needs and conditions or requires special medication and care only as follows: PLEASE LIST IN THE SECTION BELOW.
In event it should become necessary, whether in an emergency or otherwise, where said Minor Child(ren) cannot act for himself/ herself/themselves, consent is hereby given for AEC through its adult individuals serving as its agents to arrange for and consent to X-Ray examinations, anesthesia, dental, medical or surgical diagnosis and/or treatment and hospital care, for said Minor Child(ren), on behalf of Participant; and, in such event, Participant agrees to assume and pay all costs, charges, fees and expenses incurred in these premises, and to indemnify, defend and hold harmless AEC and its officers, directors, representatives, employees, and its agents therefrom. Participant represents and agrees that he/she/they already has/have or will provide insurance coverage or payment of such things, at Participant’s own expense.
SIXTH: DISCIPLINE-Participant for himself/herself/themselves and on behalf of such Minor Child(ren) hereby submits to and agrees to abide by all rules and regulations, supervision and discipline set and applied by AEC or its agents, and it is agreed that for violation of such rules and regulations, supervision or discipline, the participation in the ACTIVITY by Minor Child(ren) or Participant may then be immediately terminated, without liability or cost on AEC or its agents.