I consent to medical and/or surgical care as may become necessary for the Participant’s well-being, should the need arise, and I understand that I will be solely responsible for the cost. I authorize Kennesaw State University to communicate in emergencies with the person(s) identified in my submission materials. I hold harmless and agree to indemnify Kennesaw State University from any claims, causes of action, damages, and/or liabilities arising out of or resulting from said medical treatment.
By signing this form, I agree that all information is accurate and current, that all important information is listed on this form, and to the best of my knowledge, my child is capable of participating safely in the Program. I acknowledge that my failure to disclose relevant information may result in harm to my child and/or others during this program. I agree to notify the program of any changes in the above information as soon as possible.
PARENT OR GUARDIAN, PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING: LIABILITY WAIVER, RELEASE, INDEMNITY AND PROMISE NOT TO SUE:
I, the undersigned below, in consideration of my child’s or ward’s participation in the Event(s) referenced above and any related activities thereto including training, preparation, and travel separately and collectively, the “Event”), wherever the/these Event(s) may occur, acknowledge that I am aware that as a result of my child’s or ward’s participation in the Event, there exists the potential for injuries including but not limited to scrapes, bruises, broken bones, and various injuries to the body, and I freely assume on my child’s or ward’s behalf all risks incidental to such participation.
In consideration of my child’s or ward’s participation in the Event and in my child’s or ward’s behalf, and on behalf of my child’s or ward’s heirs, executors, administrators and next of kin, I hereby release, covenant not to sue, and forever discharge the Released Parties (as defined below) of and from all liabilities, claims, actions, damages, costs and expenses of any nature arising out of, related to, or in any way connected with my child’s or ward’s participation in the Event and/or any such related and associated activities, and further agree to indemnify and hold each of the Released Parties harmless from and against any and all such liabilities, claims, actions, damages, costs and expenses including by way of example, but not limited to, all attorneys’ fees, costs of court, and the costs and expenses of other professionals and disbursements up through and including any appeal. This agreement to indemnify shall extend to any claim filed by my child or ward upon reaching the age of majority. I, for my child and/or ward, understand that this Release and indemnity includes any claims based on the negligence, action or inaction of any of the Released Parties and covers bodily injury (including, without limitation, death), property damage, and loss by theft or otherwise, whether suffered by me or my child or ward either before, during or after such participation. I declare that my child or ward are physically fit and have the skill level required to participate in the Event and/or any such related and associated activities. I further authorize medical treatment for my child or ward, at my cost, if the need arises. For the purposes hereof, the “Released Parties” are: Kennesaw State University, the Board of Regents of the University System of Georgia, all Event sponsors, and each of their respective parent, subsidiary, affiliated or related companies; and the officers, directors, employees, agents, representatives, successors, assigns and volunteers of each of the foregoing entities.
I also acknowledge that persons employed by Kennesaw State University may take photographs and/or videos of my child’s or ward’s participation and allow the use of these materials on behalf of the University without limitation or compensation including the release of my and/or my child’s or ward’s name. I also agree that during the time my child or ward is involved with the Event, he or she will be bound by all rules, regulations, policies, procedures and guidelines of Kennesaw State University and the Board of Regents.
This Waiver and Release Form shall be governed by the laws of the State of Georgia, and any legal action related to or arising out of this Waiver and Release Form shall be commenced exclusively in the Superior Court in and for Cobb County, Georgia. I understand that the acceptance of this liability waiver, release, indemnity and promise not to sue Kennesaw State University or the Board of Regents of the University System of Georgia or any agent or employees thereof, shall not constitute a waiver, in whole or in part, of sovereign or official immunity by said Board, its members, officers, agents and employees.
I certify I am eighteen (18) years of age or older and, if I am executing this Waiver and Permission Form on behalf of my child or ward, the information set forth above pertaining to my child or ward is true and complete.
I HAVE READ, UNDERSTOOD AND ACCEPT THE CONDITIONS OF THIS LIABILITY RELEASE, INDEMNITY, AND
PROMISE NOT TO SUE.
I acknowledge persons employed by Kennesaw State University may take photographs and/or videos of the participant named above and allow the use of these materials on behalf of the University without limitation or compensation.