Village of Campbellsport
VOLUNTARY RELEASE, ACKNOWLEDGEMENT
AND ACCEPTANCE OF RISKS BY PARTICIPANT DURING
COVID-19 PANDEMIC OF 2020-2022
Risk of Injury : “As a participant in the program, or as a parent or legal guardian of the participant under 18 years of age, I recognize and acknowledge that there are certain risks of physical injury, and I assume the full risk of injuries, including death, damages, or loss which I may sustain as a result of participating in any and all activities associated with this program.”
Waiver of Injury Claims : “I agree to waive and relinquish any and all claims I may have arising out of, connected with, or in any way associated with the activities of the program.”
Risk of Illness : “As a participant in the program, or as a parent of legal guardian of the participant under 18 years of age, I recognize and acknowledge that there are certain risks of possible exposure to and illness from infectious diseases including but not limited to MRSA, Influenza, and Covid-19. While particular rules and personal discipline may reduce this; risk of serious illness and death does still exist. I agree to assume the full risk of injuries, including death, damages, or loss which I may sustain as a result of participating in any and all activities associated with this program.”
Release of Liability : “I do hereby full release and discharge the Village of Campbellsport/Campbellsport Athletic Association and its officers, agents, and employees from any and all claims from injuries, including death, damages and loss which I or my minor child/ward may have or which may occur on account of participation in the program.”
Indemnity and Defense : “I further agree to indemnify, hold harmless and defend Village of Campbellsport/Campbellsport Athletic Association and its officers, agents, and employees from any and all claims from injuries, including death, damages and loss which I or my minor child/ward may have or which may occur on account of participation in the program.” In the event of an emergency, I authorize the Village of Campbellsport/Campbellsport Athletic Association to secure from any licensed hospital, physician, and /or medical personal any treatment deemed reasonable and necessary for my minor child’s immediate care and agree that I will be responsible for payment of any and all medical services rendered.