PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT BETWEEN THE PARENT/GUARDIAN (I) AND the JAMES AND DOROTHY DOSS HERITAGE AND CULTURE CENTER OF PARKER COUNTY TEXAS (DHCC). THIS FULLY SIGNED FORM MUST BE SUBMITTED BY A PARENT OR LEGAL GUARDIAN BEFORE ANY CHILD IS ALLOWED TO PARTICIPATE IN THE ABOVE REFERENCED PROGRAM/CAMP.
I, the undersigned, wish for my Child (hereafter “Child”) to participate in the above referenced camp/program (hereafter “Camp”) on the date(s) and location indicated above and, in consideration for my Child’s participation, I hereby agree as follows:
I acknowledge, understand and appreciate that as part of my Child’s participation in the Camp there are dangers, hazards and inherent risks to which my Child may be exposed, including the risk of serious physical injury, temporary or permanent disability, and death, as well as economic and property loss. I further realize that participating in the Camp may involve risks and dangers, both known and unknown, and have elected to allow my Child to take part in the Camp.
I, on behalf of my Child, hereby understand and acknowledge that my failure to disclose relevant information may result in harm to my child and/or others during this Camp. By signing my name, I represent and warrant that my child's mental, physical or medical condition enables him/her to participate in the Camp without any special accommodation.
I, on behalf of my Child, hereby release DHCC, its Board of Trustees, Staff, Volunteers, Camp Staff, and all other officers, directors, employees and agents from any and all liability as to any right of action that may accrue to my heirs or representatives for any injury to my Child or loss that my Child may suffer while participating in the Camp. This agreement is binding on my heirs and assigns.
I, on behalf of my Child, furthermore release, indemnify and hold harmless DHCC from and against any and all liability, actions, debts, claims and demands of every kind whatsoever, specifically including, but not limited to, any claim for negligence or negligent acts or omissions and any present or future claim, loss or liability for injury to person or property that my Child may suffer, for which my Child may be liable to any other person, that may or does arise out of my Child’s participation in the Camp. I understand that DHCC accepts no responsibility for my Child’s personal property.
I, on behalf of my Child, furthermore acknowledge that DHCC does not provide on-site medical care or provide and administer any prescription or over-the-counter drugs and in the event of an accident or serious illness without permission from the parent or legal guardian, I hereby authorize representatives of DHCC to obtain emergency medical treatment for my Child on my behalf. I hereby hold harmless and agree to indemnify DHCC from any claims, causes of action, damages and/or liabilities, arising out of or resulting from said medical treatment. I further agree to accept full responsibility for all expenses, including medical expenses that may derive from any injuries to my Child that may occur during his/her participation in the Camp.
By checking the appropriate box below I, on behalf of my Child agree or disagree to give DHCC permission to use the electronic image of my Child on DHCC’s website or in DHCC publications and I agree to indemnify and hold harmless DHCC, its Board of Trustees, Staff, Volunteers, Camp Staff, and all other officers, directors, employees and agents from any and all liability as to any right of action that may accrue to my heirs and assigns as a result of DHCC using my Child’s image.
This RELEASE shall be governed by and construed under the laws of Texas. I agree that any legal action or proceeding relating to this RELEASE, or arising out of any injury, death, damage or loss because of my Child’s participation in any part of the Camp, shall be brought only in Parker County, Texas.
This RELEASE contains the entire agreement between the parties to this agreement and the terms of this RELEASE are contractual and not a mere recital. The information I have provided is disclosed accurately and truthfully. I have been given ample opportunity to read this document and I understand and agree to all of its terms and conditions. I understand that I am giving up substantial rights (including my right to sue), and acknowledge that I am signing this document freely and voluntarily, and intend by my signature to provide a complete and unconditional release of all liability to the greatest extent allowed by law. My signature on this document is intended to bind not only myself and my Child but also the successors, heirs, representatives,
administrators, and assigns of my Child and myself.
By continuing your registration and payment for this program/camp you certify that you have read and agree to the above information.
