WAIVER, RELEASE AND ASSUMPTION OF RISK AGREEMENT AND AUTHORIZATION FOR EMERGENCY TREATMENT OR TRANSPORTATION
I, the undersigned, as participant, or as parent or legal guardian of the child listed on this form, hereby assume full responsibility for all risk of injury or loss which may result from my or my child’s
participation in the program listed below, and hereby agree to hold harmless, release and forever
discharge Outdoor Afro, its officers, directors, agents and employees and their representatives, from any and all claims and demands whatsoever which the undersigned, and any of them or any third party and their representatives or any person acting under their behalf have, or may have, against Outdoor Afro by reason of any accident, illness, injury, or death to any person or persons, or damage to, loss of or destruction of property arising or resulting directly or indirectly from my or my child’s participation in the aforementioned activity, and occurring during said participation, or anytime subsequent thereto regardless of whether said claims or demands arise out of negligence on the part of Outdoor Afro, or its leadership. The terms of this release shall serve as a release and assumption of risk for myself, my child, heirs, executives, administrators, and for all of my family members.
I understand, agree, and acknowledge that some activities in this program may be of a hazardous nature and/or include physical and/or strenuous activity. I hereby assume all risk of such activities.
Understanding this, I state to the best of my knowledge that I or my child listed on this form have no medical, physical, mental, or emotional health conditions which would hinder my or my child’s active participation in the program listed on this form.
In the case of an emergency in which I am not able to give permission for medical treatment and my designated emergency contact cannot be reached, I authorize the staff or agents of Outdoor Afro to obtain whatever medical treatment is deemed necessary for my or my child’s welfare. In the case of my child, this authorization is given pursuant to the provisions of the laws of my state. I further understand and agree that I will be financially responsible for all charges and fees incurred in the rendering of said emergency treatment, regardless of whether my medical insurance would cover such charges and fees.
I give my full permission to Outdoor Afro and any other media sources to use my or my child’s name and any photographs, videographs, website, motion pictures or recordings for any publicity and promotional purposes without obligation or liability to me.
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health
Organization. COVID-19 is extremely contagious. Although medical knowledge of COVID-19
is constantly evolving, the virus is believed to spread from person-to-person contact, by contact
with contaminated surfaces and objects, in the air and even by people who are infected but show
no symptoms. The precise methods of spread and contraction are not completely understood, and
there is no known treatment or cure for COVID-19. Evidence has shown that COVID-19 can
cause serious and potentially life-threatening illness and even death. Adults over age 65 and people
of any age with serious underlying medical conditions including, but not limited to, asthma, high
blood pressure, pregnancy, HIV, cancer, weakened immune system, serious heart condition, sickle
cell disease, diabetes or obesity may be at a higher risk of severe illness resulting from COVID-19.
As a result, federal, state and local governments and federal and state health agencies recommend
social distancing. While particular rules and personal discipline may reduce this risk, the risk of
serious illness and death does exist.
By signing this Release, I acknowledge that while Outdoor Afro has put in place preventative
measures to reduce the spread of COVID-19, Outdoor Afro cannot guarantee that I or my child
will not be exposed to, contract or spread COVID-19 while attending the program listed below.
Given the incompleteness of medical knowledge about COVID-19 and the manner and ease of
its transmission, it is not possible to fully prevent against the presence or transmission of the
disease. Therefore, I understand and acknowledge that by choosing to attend the program below
in person, I may be exposing myself or my child to, and/or increasing my or my child’s risk of
contracting or spreading COVID-19. I understand and acknowledge that such exposure or
infection may result in personal injury, illness, permanent disability, and/or death.
By signing this Release, I acknowledge the importance of complying, and agree to fully comply,
with all applicable federal, state and local laws, as well as policies, rules, regulations and
instructions from any source or authority, including the Outdoor Afro Program Leader and the
manager of the host location, regarding the use of the host location’s facilities, including those
related to social distancing precautions, wearing face coverings, following signage instructions
and good hygiene practices. I understand that any failure to do so will result in my or my child’s
removal from this program and the host location site. In addition, if I or anyone in my household
feels sick or exhibits any symptoms of illness (including, but not limited to, fever, cough or
shortness of breath), I or my child will not attend this program in person.
By signing this Release, I acknowledge that I have read and understood the above warning
concerning COVID-19. I choose to accept the risk of COVID-19 in order to and as a condition
of attending the program in person at the host location. I understand the contagious nature of
COVID-19, and, to the fullest extent permitted by law, I voluntarily assume the risk that I may
be exposed to, be infected by and/or spread COVID-19 by attending the program in person. I
understand that the risk of becoming exposed to, infected by or spreading COVID-19 by
attending the program in person may result from the actions, omissions or negligence of myself
or others, including, but not limited to, Outdoor Afro employees, volunteers, program
participants and other visitors to the host location.
Without limiting the release above, I, for myself, my family, my beneficiaries, heirs, assigns and
anyone acting for me, hereby agree to hold harmless, release and forever discharge Outdoor
Afro, its officers, directors, agents and employees and their representatives from all liabilities,
claims, actions, damages, costs or expenses of any kind arising out of or relating to exposure,
infection, and/or spread of COVID-19 associated with my in-person attendance in the program
listed below. I understand and agree that this Release means that I, my beneficiaries, heirs,
assigns and anyone acting for me give up the right to bring any claims, including for personal
injury, death, disease, property loss or any other loss or damage, including claims based on
negligence. I also understand that to the fullest extent permitted by law, I give up any claim I,
my beneficiaries, heirs, assigns and anyone acting for me, may have to seek damages or other
relief, whether known or unknown, foreseen or unforeseen.
I agree that this Release shall be governed by and construed in accordance with the laws of the
State of California, without regard to any conflicts of laws provisions. I agree that if any of the
provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as
possible, and the unenforceable provision(s) shall be deemed modified to the limited extent
required to permit enforcement of the Release as a whole. I intend that this Release shall be
construed broadly to provide a release and waiver to the maximum extent permissible under