WAVIER AND RELEASE OF LIBILITY

WAVIER AND RELEASE OF LIBILITY (READ BEFORE SIGNING)

In consideration of being allowed to participate in any way in the CATHOLIC CHARITIES Camp I Am Special Flag FootballTournament (12/30/2016) related events and activities, the undersigned acknowledges, appreciates, and agrees that:

  1. The risk of injury from the act from the activities involved in the program is significant, including the potential for permanent paralysis and death, 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 negligence of the releaseor 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 attention to the nearest official and Rebecca Aleman, Director immediately.
  4. I, for myself and on the behalf of my heirs, assign, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Catholic Charities Camp I Am Special, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners, and lessors of the premises used to conduct the event. With respect to any and all injury, disability, death, or loss or damage to a person or property, whether arisingfrom negligence or the release 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 voluntarilywithout inducement.

My permission is granted to photograph and to use, publish and release for publication such photos relating to your programs. The name of my camper may be used in connection with the above, with the understanding that there will be no exploitation and that any photographs used will conform to standards of good taste. Photos will be used for Catholic Charities Camp I Am Special, Diocese of St. Augustine program websites, social media, media, and newsletter publications.

Participants Name: ______Age: ______

*If under 18 years of age parent and/or guardian must sign the release*

Parent/Guardian Printed Name: ______

Parent /Guardian Signature: ______Date: ______

Participants Signature: ______Date: ______