WAIVER, RELEASE AND IDEMIFICATION
In consideration for permission from Markham Wesley Centre (MWC hereafter) to participate in program and in full recognition and appreciation of the dangers and risks inherent in the Activity, I hereby waive, release, and forever discharge MWC (and all of its affiliates, elected officials, directors, officers, employees, contractors, agents, volunteers and those for whom MWC is in law responsible) from and against any and all liability, claims, demands, actions, or causes of action for costs, expenses or damages to property or personal injury (including death) (collectively, “Liability”), which may result from my or my child’s participation in the Activity due to any cause whatsoever, including without limitation, negligence, or breach of any statutory or other duty of care on the part of MWC. I further hereby agree to hold harmless and indemnify the Releases from and against any and all Liability which may result from, or is in any way connected with, my or my child’s participation in the Activity.
ACKNOWLEDGMENT OF RISKS
I understand and acknowledge that participation in the Activity is voluntary. I understand and acknowledge that the Activity may be hazardous, that participation is solely at my own risk, and that I assume full responsibility for any injuries (including death) or damages resulting from my or my child’s participation in the Activity. I affirm that I am, and/or my child is, in good health and at an appropriate level of physical fitness and physical capability to participate in the Activity. I affirm that I am at least 18 years of age, or that I am the parent and/or legal guardian of the child listed below and I hereby consent to their participation and waive liability on their behalf.
CONSENT TO USE IMAGE
I hereby consent and authorize MWC to take my photograph/image and/or the photograph/image of the child listed below, for whom I am the parent and/or legal guardian (collectively, “Image”). I acknowledge and agree that MWC may publish, display or use the Image for any MWC purpose and by any means whatsoever including, but not limited to, electronic or digital means. I acknowledge that MWC may not be able to control the distribution or use of the Image by other than MWC representatives. I agree that this consent is given in perpetuity and for no consideration, credit, acknowledgement or financial recompense, now and in the future. I hereby waive, release, and forever discharge the Releases from and against any and all Liability whatsoever which may result from the taking, use, display, publication or distribution of the Image.
BY CHECKING THE BOX PROVIDED BELOW, THE PARTICIPANT / GUARDIAN ACKNOWLEDGES HAVING READ THIS DOCUMENT AND UNDERSTANDS THAT THE PARTICIPANT / GUARDIAN IS WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.