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1/1/2022 – 12/30/2022

WAIVER OF LIABILITY AND PERMISSION FORM

If you have signed a waiver in the past,  you do not need to sign another.

I understand that I and my child will be participating in activities at the Agua Hedionda Lagoon Foundation, a California public benefit corporation (AHLF) and that in the course of such activities my child and I may have direct contact with animals. I further understand that while precautions are taken to ensure participant safety, the behavior of animals is sometimes unpredictable and that some animals are capable of inflicting serious personal injury, as well as carrying infectious diseases that could lead to illness and/or death if not treated properly. In consideration for the participation by my child in such activities, I hereby WAIVE, RELEASE, AND DISCHARGE the AHLF from any and all liability (including but not limited to, liability arising from the negligence or willful misconduct of the entities or persons released) AHLF and/or its directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers.

In the event that my child is injured or becomes ill, I hereby give the AHLF authority to seek emergency medical treatment for my child and intend that the foregoing release shall apply to any cause of action that arises in the course of such treatment. I hereby represent and warrant (i) that I am the parent or legal guardian of the child named below; (ii) that my child has no medical or other condition that would prevent my child from participation in activities at the AHLF; and (iii) that I have fully read and understood this release.

All participants must sign waiver

 


First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information
Member*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Member*
No
Yes
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Member*
No
Yes
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Member*
No
Yes
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Member*
No
Yes
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Member*
No
Yes
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Member*
No
Yes
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Member*
No
Yes
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Member*
No
Yes
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Member*
No
Yes
Parent or Guardian's Email Address

Email
Check to receive information, news, and events by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
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*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Member*
No
Yes
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.


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