Activity Agreement and Release Form for Student Participation in Challenge Course

Activity Agreement and Release Form for Student Participation in Challenge Course

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Student/Participant Name*

Parent/Guardian #1 Name*
Address*

Parent/Guardian #2 Name
Address

Park School of Baltimore (“Park” or the “School”) is offering the opportunity to participate in a challenge course (the “Activity”), which includes but are not limited to zip lining, high ropes courses, team building exercises, climbing ladders, giant swings, rock climbing, hiking, canoeing, rappelling, caving, backpacking, camping, and being transported in a commercial passenger van or bus. The undersigned Parent(s)/Legal Guardian(s) (the “Parents”) of the above-named student (the “Participant”) who will participate in the Activity. In consideration for the Participant’s participation in the Activity, Parents and Participant hereby agree to the terms and conditions below:


  1. Voluntary Participation: Parents understand that the Participant’s participation in the Activity is entirely voluntary. Parents acknowledge that the Participant is enthusiastic, prepared to fully participate and is able and willing to follow the instruction of Park staff, including safety instructions and other instructions regarding the proper use of any necessary safety equipment, and will meet the conduct expectations of the Activity.

  2. Waiver, Release of Liability and Indemnification: Parents authorize and give permission for the Participant to participate fully in the Activity, which includes strenuous physical activity. Parents acknowledge that the School will have staff members who will be conducting the Activity and they will implement reasonable safety precautions to protect the safety of participants during the Activity; however, Parents also understand that it is not possible for the School to supervise all aspects of the Activity at all times. Parents understand that there are inherent risks of illness, serious personal injury and loss, death, theft, or damage of personal property involved in the Activity, and Parents voluntarily assume and accept such risks of illness, personal injury and loss, theft or damage of personal property arising from or as a result of the Participant’s participation in the Activity. Parents release the School, its Trustees, employees, and agents from all claims, liability, and damages that Parents or the Participant may have for illness, personal injuries or property damage, death, loss or theft resulting from Participant’s participation in the Activity. Parents agree that this release includes illness, personal injury or loss, theft or damage of personal property caused by or resulting from negligence, active or passive, of the School, its Trustees, employees, and agents; however the release does not apply to liability for gross negligence, willful injury, or fraud, and is not intended to release the School’s insurers, if any, or non-agent third parties of any responsibility for any claims that may otherwise be asserted. Further, Parents hereby release, discharge, indemnify, and hold harmless the School from any and all losses, financial liability or expenses, obligations, claims, judgments, liabilities (including attorney’s fees) of any nature arising out of, or in consequence to the Participant’s participation in the Activity, including, but not limited to, damage to property, bodily or personal injuries, illness, loss of companionship or support or death sustained by any person(s) as a result of the Participant’s actions, activity or inactivity.

  3. Medical Information, Emergency Contact, and Permission to Treat: By signing below, Parents attest that Participant does not have any health condition(s) or medical restriction(s) that may or may not impact the Participant’s ability to participate in the Activity. In addition, Parents must provide the School with the name and contact information of an Emergency Contact. Failure to provide the School with the name and contact information for an Emergency Contact may result in the School’s decision not to permit the Participant to participate in the Activity. In the event of a medical emergency, the School will make reasonable attempts to first contact the Parents, and if unable to reach the Parents, the school will contact the Emergency Contact listed below.

  4. Acts Beyond the School’s Control: Parents understand and acknowledge that the School is not responsible for events, acts, or omissions beyond its control such as, without limitation, any illness, injury, loss, death, inconvenience, delay, or damage to personal property, whether resulting from weather, pandemic, acts of God, government restrictions, acts of war or civil unrest, strikes or other labor activities, criminal or terrorist activities of any kind and/or mechanical or other failure of means of transportation. Parents voluntarily accept these as risks of participation in the Activity, and agree to release the School from any and all claims arising out of such events, acts, or omissions.

  5. Miscellaneous: This Authorization and Release from Liability represents the full and complete understanding between the School and the Parents regarding the Participant’s participation in the Activity. This Authorization and Release from Liability supersedes all prior agreements, statements, or representations, whether written or oral, concerning the subject matter of this Agreement. This Authorization and Release from Liability may not be altered, amended, modified or otherwise changed except in writing, signed by the School and the Parents. Invalidity or unenforceability of one or more provisions of this Authorization and Release from Liability shall not affect any other provision and the remainder of this Authorization and Release from Liability shall remain in full force and effect. This Authorization and Release from Liability is subject to the laws of the State of Maryland.

Emergency Contact Information

In the event of a medical emergency, the School will make reasonable attempts to first contact the Parents, and if unable to reach the Parents, the Emergency Contact listed below:
Emergency Contact Name*
Address*

Parent/Guardian Signature*
MM slash DD slash YYYY
Parent/Guardian Signature
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Participant Signature*
MM slash DD slash YYYY
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