BAKER SANCTUARY HIKING CLUB
Registration Form
Name of Adult:Address:
City: / State: / Zip:
Email:
Phone: / Cell Phone:
Minor’s Name:
Address if different from adult:
Emergency Contact Name: Phone #:
Release of Liability: The undersigned parent has agreed that parent’s child may participate in the Hiking Club at Baker Sanctuary. The undersigned understands that there are possible dangers associated with this outdoor Hiking Club. Parent acknowledges and understands that the Sanctuary is a natural, undeveloped (and developed in parts) property that includes many natural and human-made dangers, both known and hidden, and that my child may be exposed to a variety of hazards and risks, which are inherent in such a property, including but not limited to, the dangers of uneven terrain, snake bite, exposure to insects, or poisonous plants, and that such risks cannot be eliminated without destroying the unique character of the Sanctuary. Travis Audubon Society, the Sanctuary Steward, and Leander ISD have not tried to contradict or minimize my understanding of these risks and have made no representations as to any condition of the Sanctuary. I know that injuries and damages can occur by natural causes or activities of other persons, animals, or third parties, either as a result of negligence or because of other reasons. I understand that risks of such injuries and damages are involved in all outdoor activities. I further understand that at the Sanctuary there may not be rescue or medical facilities or expertise necessary to deal with the injuries and damages to which my child may be exposed.
The undersigned agrees to defend, indemnify and hold harmless Leander ISD and its employees, and the Travis Audubon Society, its employees, volunteers, general members, board members, officers, and agents, from any and all claims for bodily injury and property damage arising from participation in the above referenced Hiking Club, even if due to any negligent act or omission of the Leander ISD, its employees, Travis Audubon Society, its employees, volunteers, members, board and officers, and agents, or the participant him/herself.
Medical Authorization: Travis Audubon Society and / or Leander ISDhas my authorization to obtain necessary medical treatment in the case of illness, accident or any emergency situation that may arise and neither I nor the indicated emergency contact is able to be reached at the time of the emergency.
Photo Permission
I agree and understand that photographs and videos may be taken of my child and used by Travis Audubon on websites, eblasts, advertising, and other publicity. I hereby give Travis Audubon permission to duplicate and distribute the photographs and videos, or any parts thereof, whichincludes my child’s image, in perpetuity. In any manner and in any and all media whether known now or hereafter devised. I waive any right to inspect or approve the finished version(s).
Signature of Parent/Guardian:
(Type or sign name.)
Date: ______