In consideration of being allowed to participate on behalf of GREATER BERRIEN SPRINGS RECREATION DEPARTMENT and related events and activities, the undersigned acknowledges, appreciates, and agrees that:
1. Participation in GBSRD activities includes 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, the risk of serious illness and death does exist. 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE OTHERS, and assume full responsibility for my child’s participation in a fall sport or myself as a referee.. 3. I willingly agree to comply with the stated and customary health practices for participation in regards to protection against infectious diseases. If, however, I observe any unusual symptoms in my child (fever, chills, cough, shortness of breath, body aches, loss of taste/smell. nausea, vomiting, diarrhea), during their presence or participation, I will remove myself or my child(ren) from participation and bring it to the attention of the nearest official immediately; and, 4. I, for myself and on behalf of my heirs, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Greater Berrien Springs Recreation Department and their officers, board of directors, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
Name of participant(s) (required)
Name of parent/guardian: (required)
Parent/guardian signature: (required)
Date Signed: (required)
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