By signing this form, you will waive certain rights ON BEHALF OF YOURSELF AND YOUR CHILD. Please read carefully.
In the event of injury, the City of Irvine (“City”) has my consent to secure medical treatment for my child. I understand and acknowledge that I will be responsible for payment of all medical services rendered, including reimbursement to the City for any medical expenses incurred in the care of my child.
The City has my consent to photograph me and/or my child participating in the programs for use in future City publicity. I understand and acknowledge that my child and I will not receive compensation for such use.
The City has my consent to take my child on offsite excursions under the supervision of the City. I understand and acknowledge that modes of transportation for offsite excursions may include, without limitation, City vehicles, vehicles under contract with the City or walking to local sites.
I, on behalf of myself and my child, understand and acknowledge that participation in the programs may involve the risk of serious injury which may result not only from my child’s actions, but also from the actions, inactions or negligence of others, the condition of the facilities, equipment or areas where the program is being conducted, or the nature of the program itself. I, on behalf of myself and my child, understand and acknowledge that my child is voluntarily participating in the program(s) with knowledge of the danger involved, and agree to accept and assume any and all risks of personal injury, wrongful death, property damage or other loss from participation in the programs and/or activities.
I, on behalf of myself and my child and our heirs, successors and assigns, agree to hold harmless, release, indemnify, and defend the City, and its respective officers, employees, agents, representatives, sponsors, volunteers, successors, and assigns from any and all liabilities, losses, damages, claims, costs, demands or causes of action arising out of or related to my child’s participation in the program(s), howsoever caused, whether caused by action, inaction or active or passive negligence, and whether caused by the City, my child or any other individual or entity.
I HAVE CAREFULLY READ THIS WAIVER, RELEASE OF LIABILITY, AND ASSUMPTION OF RISK AGREEMENT AND UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS DOCUMENT RELIEVES THE CITY AND OTHERS FROM LIABILITY FOR PERSONAL INJURY, WRONGFUL DEATH AND PROPERTY DAMAGE, AND, ON BEHALF OF MYSELF AND MY CHILD, SIGN IT VOLUNTARILY.