Participant Waiver & Release
Please read this document carefully before agreeing.
Whereas, the Louise Archer Elementary School PTA (“LAES PTA”) as a service to its members and students, provides various enrichment activities for the students at Louise Archer Elementary School (LAES):
This is to certify that the undersigned, as parent/guardian with legal responsibility for the child named below, a minor under the age of 18, (the “Participant”), hereby consents to the Participant’s participation in the 2019-2020 LAES PTA Enrichment Program between August 28, 2019, and August 27, 2020, at LAES.
In consideration for being allowed to participate in the Program:
- The undersigned represents and warrants that he or she has the requisite legal authority and capacity to execute this Release on behalf of the Participant.
- The undersigned, on behalf of Participant, hereby knowingly and freely assumes all risks both known and unknown, even if arising from the negligence of the Releases or others, and assumes full responsibility for Participant’s participation.
- The undersigned, on behalf of Participant, hereby represents that the participant has no medical or other conditions that would create any risk to the Participant in performing the tasks relating to the Programs, including sports activities and the performance of certain dance and aerobic exercise and movements.
- The undersigned hereby acknowledges and understands that Participant must obey all instructions and rules from Program staff regarding participation.
- The undersigned, as parent/guardian with legal responsibility for the Participant, does hereby release, indemnify, and hold harmless the LAES PTA, including its officers, agents, members, and volunteers; Fairfax County Public Schools (FCPS), and LAES, including their officers, board members, agents, and employees; and any person or persons in charge of running the Program (the Program coordinators), the Program Vendors, their respective affiliates, successors and assigns the officers, directors, employees and agents of such parties and their affiliates (the “Releasees”) from any and all claims, demands, suits, costs (including attorneys’ fees and litigation costs) and charges, in connection with or arising out of the provided Program, with respect to any and all injury, disability, death or loss or damage to person or property incident to the Participant’s involvement or participation in the Program, whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law. I understand that this Release includes any claims based on negligence, action, or inaction of the LAES PTA, LAES, and the program coordinators and volunteers.
The undersigned, on behalf of Participant, understands that there are no medical personnel on-site or with access to the LAES clinic during enrichment programs. In the event that I cannot be reached to make arrangements for emergency medical attention, I authorize the Program coordinator or other adult present to seek immediate medical care at any facility that this person deems suitable. I further give my consent for any and all emergency medical treatment when the child/children are in this individual’s care.
This is a knowing and voluntary relinquishment of any rights and claims the undersigned, his/her spouse (if applicable) or anyone else may have on behalf of the Participant, and the undersigned does hereby acknowledge that such minor would not be allowed to participate in the Program in the absence of receipt of this Release.
I have read this Release and further agree that no oral representations, statements, or inducements apart from the foregoing Waiver and Consent have been made.