PLEASE READ THIS SECTION CAREFULLY BEFORE SIGNING, and be aware that in signing up and participating in
this program, and using the facilities and equipment, you will be waiving and
releasing all claims for injuries or loss or property damage that you (or your
child) might sustain arising in any manner out of this program or the use of
the facilities or equipment. This section must be filled out and signed by each
participant (or their parent/guardian) or they will not be allowed to
participate in this program or use the facilities or equipment.
PHOTOGRAPHIC RELEASE – In consideration of the furtherance of the purpose of the Epilepsy
Foundation of Northern California and the Epilepsy Foundation of America, I
hereby grant permission to the same, their officers, agents, and employees to
take photographs or video of me (or my child) and to use and distribute for
publication any and all such photographs, video, news releases, and stories for
any purpose they may deem proper. In granting such permission, I hereby
relinquish any right, title, and interest I may have in such photographs,
video, news releases, and stories and grant the Epilepsy Foundation of Northern
California and the Epilepsy Foundation of America the right to use these
products.
ACKNOWLEDGEMENT OF RISK OR INJURY CLAUSE – As a participant in the program, I recognize the
risk and acknowledge that there are certain risks of physical injuries,
including death, damages, COVID-19 exposure, property damage, or loss which I (or my child) may
sustain as a result of participating in any and all activities connected with
such program or the use of the facilities or equipment.
WAIVER OF CLAIM FOR INJURY CLAUSE – I agree to waive and relinquish all claims that I
(or my child) may have for injuries or damages, as a result of participating in
the program or using the facilities or equipment, against the Epilepsy
Foundation of Northern California, the Epilepsy Foundation of America, Lair of the Bear and their officers, directors, volunteers, agents,
servants, employees, and affiliates.
RELEASE FROM LIABILITY CLAUSE – I do hereby fully release and discharge the
Epilepsy Foundation of Northern California, Lair of the Bear and their officers, directors, volunteers, agents, servants, employees, and
affiliates from any and all claims for injuries, including death, damages, COVID-19 exposure, property damage, or loss which may have or which may in the future accrue to me
(or my child) on account of participation in the program or use of the
facilities or equipment.
INDEMNITY AND DEFENSE – I further agree to indemnify and hold harmless and pay
defense costs and defend the
Epilepsy Foundation of Northern California, the Epilepsy Foundation of America, Lair of the Bear and their officers, directors, volunteers,
agents, servants, employees, and affiliates, from any and all claims resulting
from injuries, including death, damages, property damage, or loss sustained by
me (or my child) and arising out of, connected with, or in any way associated
with the activities of the program or the use of the facilities or equipment.
The undersigned, in case of emergency and in the event the undersigned cannot
be reached by telephone, does hereby give permission for medical treatment by a
physician or hospital selected by camp staff. Such permission shall include any
and all medical treatment, which is necessary or desirable in the absolute
discretion of any such physician or hospital. The undersigned recognizes the
right of camp staff, in his/her absolute discretion, to terminate a camper’s
attendance at any time due to disciplinary or medical actions which might
jeopardize the camper’s or other’s health, safety, or well-being at camp. The
undersigned further agrees to pick up the camper immediately upon being
notified of such termination. If someone other than the undersigned is to pick
up the camper at the end of the camp session, such person must present WRITTEN authorization from the undersigned.