Loading...

JEC/@akiva Combined Release Form for 2021-22 Hebrew for Teens Activities

IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING

 ASSUMPTION OF RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT

This Agreement must be completed to participate in the activities associated with this program

PART 1 – RELEASE FOR USE OF IMAGES (RUI)

I hereby give my consent to @akiva and The Jewish Education Center of Cleveland (JEC) to photograph, film, videotape and then use, reproduce, and publish said images of me and/or my child/children.

I agree that photographs/negatives, film, or videotapes thereof shall constitute the sole property of @akiva and the JEC, with full right of disposition in any manner whatsoever.

I hereby release @akiva, The Jewish Education Center of Cleveland (JEC), and Jewish Federation of Cleveland from any and all claims whatsoever in connection with the use, reproduction, publication of the images thereof.

 

PART 2 – ASSUMPTION OF RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT

I the undersigned, am the parent and/or legal guardian of the minor Participant/s (“Guardian/Parent”) named in this document. I am familiar with the curriculum and the activities which take place in the above-named course.

TERMS AND CONDITIONS

I authorize my child to participate in the 2021-22 Hebrew for Teens Program Activities, sponsored by @akiva and The Jewish Education Center of Cleveland (the JEC).
I understand that such participation can include both online and in-person meetings and activities. I also understand that as a result of such participation the Participant may be subject to various foreseeable and unforeseeable risks. Guardian/parent freely voluntarily allows participation in the program with the knowledge of foreseeable and unforeseeable risks and hereby agrees to assume and accept any and all risk. I am familiar with the curriculum and the activities as described in the program information, which may take place in the above-named Program, and agree to abide by the Terms and Conditions set forth below.

WAIVER, RELEASE AND INDEMNIFICATION

Guardian/Parent of Participant understands and acknowledges that @akiva, JEC and Jewish Federation of Cleveland is not an insurer of any Participant’s behavior or actions. @akiva, Jewish Education Center of Cleveland, (JEC) and Jewish Federation of Cleveland assume no liability whatsoever for personal injuries or property damages sustained by the Participant, or to third persons, arising out of Participation in the Program activities. Guardian/Parent of Participant under the age of 18 hereby agrees to release, waive, and hold harmless @akiva, the JEC, Jewish Federation of Cleveland, and all of their Officers, Directors, Trustees, employees and agents (collectively the “Releasees”) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of, or related to participation in the above-described program. Furthermore, Parent/Guardian agree to indemnify

@akiva, the JEC, Jewish Federation of Cleveland, and all of their Officers, Directors, employees and agents, against any claim made against any of them, for any actions or conduct of the Participant.

ON MY BEHALF AND ON BEHALF OF MY CHILD, I FURTHER COVENANT AND AGREE NOT TO SUE THE RELEASED PARTIES FOR ANY CLAIMS OR DAMAGES ARISING FROM MY/MY CHILD’S PARTICIPATION IN THE ACTIVITIES OR ARISING OUT OF OTHER RISKS.

If any portion of this Agreement is held to be invalid by a court of law, then it is agreed and intended that all the remainder shall, notwithstanding, continue in full force and effect.

GUARDIAN/PARENT OF PARTICIPANT HAS CAREFULLY READ THESE TERMS AND FULLY UNDERSTANDS THEIR CONTENT AND IS AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN GUARDIAN/PARENT OF PARTICIPANT AND THE RELEASEES AND SIGNS IT OF HIS OR HER OWN FREE WILL.

I  am signing this Agreement on behalf of a minor Participant. I acknowledge that I am the Guardian/Parent of the Participant and that I understand the terms of this Agreement. I also acknowledge that these terms shall bind my heirs and personal representatives and the heirs and personal representatives of Participant.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!