PARTICIPANT WAIVER AND RELEASE OF ALL CLAIMS: Please read carefully
Participant (18 years or older or Parent/Guardian)
I recognize and acknowledge that there are certain risks of physical injury to participants in these programs, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my minor child/ward) as a result of participating in these programs against the Genoa Township Park District, including its officials, agents, volunteers and employees. I do hereby waive, relinquish and hold harmless the Genoa Township Park District and its representative from any and all liability including, without limitations to, liability for any physical or mental injury aggravation or any pre-existing illness or handicap, property damage or losses, and for any other liability or injury which may be sustained by me in travel, participating in and returning from the Program/Activity. I do hereby grant permission to use my name and/or likeness for promotional purposes or publicity.
I, as parent or guardian of the above named participant, in consideration of the acceptance of his/her entry, hereby join and confirm the above waiver and release. I certify that my child has listed his/her true birth date and that he/she does not have any physical and or mental deficiencies which may be aggravated, or in any ways endanger him/her, by traveling to, participating in and returning from Program/Activity. I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims. If registering on-line or via fax, my on-line or facsimile signature shall substitute for and have the same legal effect as an original form signature.