CITY OF CORAL SPRINGS

CITY OF CORAL SPRINGS

AMATEUR ATHLETIC

WAIVER AND RELEASE OF LIABILITY

READ BEFORE SIGNING

In consideration of being allowed to participate in any way in the  City of Coral Springs' Athletic / Skateboarding Program, related events and activities, I,  ________________________________ , the undersigned acknowledge, appreciate, and agree that:

1. The risk of injury from the activities involved in this program is signifi­cant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and condi­tions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the City of Coral Springs, its Commission members, employees, agents,  servants,   other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ( 'Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH. or loss or damage to person or proper­ty, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

 I HAVE READ THIS RELEASE OF LIABILITY .AND  ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

__________________________                               Age: __________            Date Signed: ________________

 PARTICIPANT'S SIGNATURE

CITY OF CORAL SPRINGS

MINOR CHILDREN

RELEASE AND WAIVER 

In consideration of the permission granted  __________________ (Child's Name) by the City of Coral Springs, by and through this Department, to participate in the Athletic / Skateboarding activities, including field trips that are offered, I _________________ (Name of Legal Guardian) hereby agree to sign this Release and Waiver.

Accordingly, I agree to unconditionally release, waive, and discharge the City of Coral Springs, its Commission members, employees, agents, and servants, all hereafter referred to as "releasees", from all claims and courses of action, that ______________________ (Child's Name), or child's guardian, personal representatives, assigns, heirs, and next of kin, may have for any loss, damage, or injury to person or property, whether caused by the negligence, or otherwise of the releasees. In addition, I agree to hold harmless completely, the releasees from all claims, demands, and actions arising out of my actions or involvement with the City of Coral Springs.

I certify and warrant that ________________________ (Child's Name) is in good physical condition and able to participate in the above activity or event.

I HAVE CAREFULLY READ THE FOREGOING RELEASE AND WAIVER AND KNOW THE CONTENTS THEREOF AND HAVE SIGNED THIS RELEASE AND WAIVER AS MY OWN FREE ACT.

NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN PURSUANT TO SECTION 744.301 FLORIDA STATUTES

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT EVEN IF THE CITY OF CORAL SPRINGS USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THIS ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM THE CITY OF CORAL SPRINGS IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE CITY OF CORAL SPRINGS HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

I expressly agree that this Release and Waiver is intended to be broad and as inclusive as permitted by the laws of the State of Florida, and that if any portion thereof is held invalid, it is agreed that the balance shall notwithstanding, continue in full force and effect. I have executed this Release and Waiver.

_____________________________________________           _____________________

          Parent/Legal Guardian                                                   Date

AUTHORIZATION FOR  EMERGENCY MEDICAL TREATMENT

I ____________________________________ (Parent/Guardian), hereby grant permission for my son/daughter/ward __________________________ (Child's Name) to participate in the Athletic / Skateboarding activities and any or all field trips during the activity. I also authorize the City of Coral Springs to obtain through a physician of its own choice, any emergency medical care that may become necessary for my child as a result of an accident or sudden illness.

Allergies, Medications, Special Notes: ______________________________________________________________________

Parent / Guardian / Ward Signature: _______________________________________

ACKNOWLEDGEMENT OF NO REFUND / NO MAKE UP POLICY

I understand the City of Coral Springs has a No Refund policy for fees and charges paid to this Department for activities sponsored by them. The only exceptions to this policy will be when an activity is canceled or the City alters its time. No other circumstances or situations will qualify for a refund.

By: ____________________________________________  (As Parent / Legal Guardian of Child)

Date: ____________________________