By submitting this form, I agree to the following terms and conditions: I grant permission for my child to participate in all activities, including swimming and trips away from the grounds. I agree that my child may be photographed, and their pictures may be used in future camp promotional materials, including, but not limited to the brochure and the Released Time website. Released Time is not responsible for personal property brought to Released Time. If the child’s conduct is harmful to the best interests of Released Time, the child may be dismissed at the sole discretion of the Director with no refund nor reduction of fee. I hereby give my approval for my child’s participation in any and all activities prepared by Released Time during the selected time. In exchange for the acceptance of said child’s candidacy by Released Time, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Released Time. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected sessions. In case of injury to said child, I hereby waive all claims against Released Time. Including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball, soccer and swimming. As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named child. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to Released Time, and its affiliates including Directors, Staff, and Assistants to provide the needed emergency treatment prior to the child’s admission to the medical facility. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
BY ACKNOWLEDGING AND SIGNING YOUR NAME AND INITIALS BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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