Broward Homeschool Parent Support Group
 

Activity Release Form

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1. *

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Activity Release Form

Minor Release of Liability and Waiver of Rights

 

IN CONSIDERATION OF BEING A MEMBER OF BROWARD COUNTY HOMESCHOOL PARENT SUPPORT GROUP, I/WE, THE UNDERSIGNED, INTENDING TO BE LEGALLY BOUND FOR MY/OUR FAMILY, INCLUDING ANY MEMBERS WHO ARE REGISTERED WITH MY/OUR FAMILY AND UNDER MY/OUR GUARDIANSHIP, DO HEREBY WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE BROWARD COUNTY HOMESCHOOL PARENT SUPPORT GROUP, INC., d/b/a BROWARD HOMESCHOOL PSG, BROWARD COOPERATIVE EDUCATIONAL PROGRAM AND ENCORE THEATRE.

 

ACTIVITY: Any and all activities for the 2022-2023 membership year.

 

COVENANTS AND AGREEMENTS. I/We, on behalf of myself/ourselves and our family hereby irrevocably and unconditionally agree for family members, myself/ourselves, my/our personal representatives, my/our heirs, next-of-kin, insurers, successors, and assigns, as follows:

 

  1. ASSUMPTION OF RISK. It is my/our choice to allow our family to participate in activities and such decision is knowing, voluntary, and made for the family’s enjoyment. I/We understand that their participation in activities involves inherent risks and dangers of terrain, climate, natural hazards, natural disasters, animals, insects, food and drink, customs, laws, social and sexual mores, safety practices and regulations, communications, criminal and law enforcement activities, political climate, acts of war or terrorism, driving practices, risk of disease or virus (including, but not limited to COVID-19), accident or illness, rescue operations, emergency treatment and health care that could result in property loss or damage, serious personal and bodily injury, death, and severe personal and economic losses. Further, I/we acknowledge there may be other risks not known to me/us or family or reasonably foreseeable at this time (collectively with the items listed above referred to as the “Risks”). These Risks may result not only from the family’s own actions, inactions, or negligence, but also from the actions, inactions, or negligence of others, or the condition of the facilities, equipment or vehicles. THIS MEANS I/WE UNDERSTAND AND I/WE HAVE CONSIDERED THE RISKS INVOLVED, AND I/WE VOLUNTARILY AND FREELY CHOOSE TO ASSUME THESE RISKS ON BEHALF OF MYSELF/OURSELVES AND FAMILY.

 

  1. RELEASE FROM LIABILITY. I/We, on behalf of myself/ourselves and family, fully and forever release and discharge Broward County Homeschool Parent Support Group, Inc. and its respective affiliates, members, directors, officers, employees, volunteers, agents, meeting locations and insurers (collectively referred to in this Release and Waiver as the “BCHPSG") from any and all Risks, injuries (including death), losses, damages, claims (including negligence claims), demands, lawsuits, expenses, and any other liability of any kind, of or to minors, me/us, our property, or any other person, directly or indirectly arising out of or in connection with the family’s participation in activities. THIS MEANS I AM/WE ARE MAKING THIS RELEASE FROM LIABILITY EVEN IF ANY CLAIMS THE FAMILY OR I/WE MAY HAVE ARE A RESULT OF THE NEGLIGENCE, INJUDICIOUS ACT, OMISSION OR OTHER FAULT OF BCHPSG. NOTWITHSTANDING THE FOREGOING, THIS WAIVER DOES NOT RELEASE BCHPSG FROM WILLFUL MISCONDUCT.

 

  1. . INDEMNITY. I/We, on behalf of myself/ourselves and the family, will defend, indemnify, hold harmless and reimburse BCHPSG from and for all damages, losses, costs, or expenses (including legal fees) incurred by BCHPSG or paid by them to any person (including me/us or my/our insurers) in respect of any accident, injury (including death), loss, or property damage, however, caused resulting from, arising out of, or otherwise in connection with the family’s participation in activities. THIS MEANS I/WE WILL REIMBURSE BCHPSG IF ANYONE MAKES A CLAIM AGAINST BCHPSG IN CONNECTION WITH THE FAMILY’S PARTICIPATION IN ACTIVITIES.

 

  1. COVENANT NOT TO SUE. I/We, on behalf of myself/ourselves and the family, will not initiate any claim, lawsuit, court action or other legal proceeding or demand against BCHPSG, nor join or assist in the prosecution of any claim for money or other damages which anyone may have, on account of injuries (including death), losses, or damages sustained by me/us, other parties or my/our (or others') property in connection with the family’s participation in activities, and I/we waive any right I/we or the family may have to do so. THIS MEANS THAT I/WE OR THE FAMILY CANNOT SUE TO HOLD BCHPSG RESPONSIBLE FOR ANY INJURY, LOSS, OR DAMAGE SUSTAINED BY FAMILY, ME/US, OTHER PARTIES OR OUR (OR OTHERS') PROPERTY IN CONNECTION WITH ACTIVITIES, EVEN IF IT IS DUE TO THE NEGLIGENCE, INJUDICIOUS ACT, OMISSION OR OTHER FAULT OF BCHPSG. I/We, on behalf of myself/ourselves and family, waive my/our insurers' right to make a claim against BCHPSG based on payments by insurers to family, me/us or on our behalf for any reason. THIS MEANS MY/OUR INSURERS HAVE NO RIGHTS OF SUBROGATION AGAINST BCHPSG.

 

  1. MEDICAL EXPENSES. I/We, on behalf of myself/ourselves and family, hereby consent to the family member’s receipt of medical treatment which may be deemed necessary in the event of any illness, accident or injury or medical emergency resulting from or in connection with the family’s participation in activities and understand that I am/we are solely responsible for all costs related to such medical treatment or medical transportation; and will reimburse BCHPSG for any medical expenses paid on the family’s behalf.

 

  1. PUBLICITY. I/We, on behalf of myself/ourselves and family, hereby grant BCHPSG, without limitation, the right to use my/our family’s name and likeness in connection with activities for any publicity without further compensation or permission.

 

 

I/WE HAVE READ THIS RELEASE OF LIABILITY AND WAIVER OF RIGHTS, INCLUDING THE COVENANTS AND AGREEMENTS CONTAINED HEREIN, FULLY UNDERSTAND ALL THE TERMS, UNDERSTAND THAT I/WE, ON BEHALF OF MYSELF/OURSELVES AND OR(S), AM/ARE VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS BY SIGNING BELOW, AND HAVE SIGNED THIS RELEASE, INCLUDING THE COVENANTS AND AGREEMENTS CONTAINED HEREIN, FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT, ASSURANCE OR GUARANTEE OF ANY NATURE BEING MADE TO ME/US.

 

I/WE HEREBY WARRANT THE TRUTH OF THE ABOVE STATEMENTS AND I/WE DECLARE THAT I/WE HAVE NOT WITHHELD ANY INFORMATION THAT WOULD INFLUENCE THE DECISION OF BCHPSG IN ALLOWING FAMILY TO PARTICIPATE IN ACTIVITIES, INCLUDING, WITHOUT LIMITATION, ANY TRANSPORTATION PROVIDED BY ME, BCHPSG OR OTHER PARTIES.

 

 

 

 

 

 

 

 

 

2. *

By checking the box below, I affirm that I have read, acknowledge, agree to abide by, and have submitted the Activity Release Form.

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Yes, I agree
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