Pre-K Just For Kicks Kickball

Please include emergency contacts if applicable. Note: Children will not be released other than to those on this list. Photo identification may be required from anyone other than a parent or guardian.

In consideration of participating at The After-Glow Centre, I represent that I understand the nature of this activity and that the participant(s) listed above is qualified, in good health, and in proper physical condition to participate in such activity. I acknowledge that if I believe event conditions are unsafe, the above participant(s) 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 the above participant(s)’s own actions, 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 and the above participant(s) 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 the above participant(s)’s 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 the participant(s) listed above’s participation in these activities or the above participant(s)’s use of The After-Glow 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. The above participant(s)’s participation in these activities is purely voluntary, and they 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.

Should it be necessary, in the opinion of a staff member of The After-Glow Centre to render first aid and assistance to the participant(s) listed above, I hereby grant permission to the staff of The After-Glow Centre and other medical personnel to render such aid and assistance as they may deem necessary.

1. I give permission for the participant(s) listed above to participate in Kids Core activities such as group led enrichment, arts & crafts, weekly tidbits, outdoor play, etc. at The After-Glow Centre. 2. I give permission for the participant(s) listed above to be included in pictures or other publicity connected with the program, including Instagram, Facebook and other social media platforms. 3. I understand that full payment must be made on Mondays each week for my child to attend program. 4. If the participant(s) listed above is not picked up by the designated time, a $10 late fee will be assessed for each 5 minutes past the designated pick up time.

The After-Glow Centre will hold a credit/debit card or bank checking account on file for payment purposes. Your credit/debit card or bank checking account information will be secure and can only be charged under the terms you specify below. By providing us with your credit/debit card or bank checking account Information, you authorize The After-Glow Centre to automatically charge your card/account on a weekly basis. Cards/accounts will be run each Monday morning for the current week. Parents will be immediately notified if the card/account on file cannot adequately charge fees. Payment must be completed to secure the child's spot in program. If the credit/debit card or bank checking account information on file changes for any reason, you must notify The After-Glow Centre as soon as possible. We will maintain a clear record of all payments and charges. An email receipt will be sent to you as soon as the payment goes through.