Waiver

"*" indicates required fields

Parent/Guardian Name*
Address*
Have you ever been enrolled at After Glow?*
Would You Like to Receive Information About the After-Glow Centre Classes, Trials, etc.*
Participants*
Childs Name
Date Of Birth
 
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Assumption of Risk Waiver of Liability-Medical Authorization-Photo Release*

At The After-Glow Centre we provide your child with a Fun and Safe as possible atmosphere for your child. However, accidents can happen therefore we must have your prior consent for your child to be able to participate at The After-Glow Centre. You must fill out this form completely and signing is required to participate. YOU MUST HAVE THIS FORM AT SIGN-IN TO JOIN

In consideration of participating at The After-Glow Centre, I represent that I understand the nature of this activity and that I am qualified, in good health, and in proper physical condition to participate in such activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in activity. I fully understand that this activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own action, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the "releases" named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation in the activity. I hereby release, discharge, and covenant not to sue The After-Glow Centre, its respective administrators, directors, agents, officers, volunteers, employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the activity takes place (each are considered "releases") from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of the "releases" or otherwise, including negligent rescue operations and further agree that if, despite this waiver and release of liability, and assumption of risk, I or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost, which any may incur as the result of a such a claim. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless The After Glow Centre from any and all claims, demands, or causes of action, which are in any way connected with my participation in these activities or my use of The AfterGlow Centre's equipment or facilities, including any such claims which , I, my children, parents, heirs, assigns, personal representative and estate have or may have that allege ordinary negligent acts or omissions of The After-Glow Centre. My participation in these activities is purely voluntary, and I elect to participate in these activities in spite of the risks. I have read the Assumption of Risk, Indemnity Agreement, and Release of Liability , I understand that I have given up substantial rights by signing it and have signed if freely and without any inducement or assurance of any nature and intend to be a complete and unconditional release of liability to the greatest extent allowed by law and agree that any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.