Loading...

IMPORTANT LEGAL NOTICE: BY SIGNING THIS AGREEMENT, PARENT/GUARDIAN CONSENTS TO THE MINOR'S PARTICIPATION, ACKNOWLEDGES THE RISKS DESCRIBED BELOW, RELEASES PARENT/GUARDIAN'S OWN CLAIMS, INCLUDING CLAIMS ARISING FROM ORDINARY NEGLIGENCE AND, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, AGREES TO A RELEASE OF CLAIMS BELONGING TO THE MINOR. PLEASE READ THIS AGREEMENT CAREFULLY BEFORE SIGNING 

This Release, Assumption of Risk, Consent, and Media Consent (the "Agreement") is entered into by the undersigned parent or legal guardian ("Parent/Guardian"), individually and on behalf of the minor participant identified below (the "Minor"), in favor of Great Plains Society for the Prevention of Cruelty to Animals, Inc. ("Great Plains SPCA") and its officers, directors, employees, volunteers, agents, representatives, sponsors, successors, and assigns (collectively, the "Released Parties"). Parent/Guardian represents that Parent/Guardian is the Minor's parent or duly appointed legal guardian and has legal authority to consent to the Minor's participation. Parent/Guardian authorizes the Minor to participate in Great Plains SPCA-sponsored programs, volunteer work, events, animal handling, premises activities, and other activities authorized by Great Plains SPCA (individually “Activity” and collectively, the "Activities") occurring in Kansas and/or Missouri. Participation is voluntary and may involve physical activity, close contact with animals, use of equipment, and other potentially hazardous conditions. Unless Great Plains SPCA requires a replacement agreement, this Agreement applies to each Activity in which the Minor participates after the date signed while the Minor remains under 18 years of age 

1.        ANNUAL TERM; COVERED ACTIVITIES.This Agreement is effective on the date Parent/Guardian signs below (the "Effective Date") and remains in effect until the earlier of (a) 11:59 p.m. local time on the day immediately preceding the first anniversary of the Effective Date, or (b) the Minor's eighteenth (18th) birthday (the "Term"). It applies to each and every Activity in which the Minor participates during the Term, whether participation occurs on one or multiple occasions, on or off Great Plains SPCA premises, and in Kansas or Missouri. If the Minor reaches age 18 during the Term, the Minor must execute Great Plains SPCA's then-current Adult Participant Release before any further participation. This Agreement does not automatically renew. Great Plains SPCA may require Parent/Guardian and the Minor to execute a new, replacement, or supplemental agreement at any time as a condition of participation, including for an Activity involving additional or different risks. Nothing in this Agreement creates a right to participate in any Activity. Expiration or earlier termination of the Term does not affect any release, waiver, assumption of risk, indemnification, media authorization, or other provision applicable to an Activity, occurrence, recording, claim, or obligation arising during the Term, and those provisions survive to the extent necessary to give them effect.

2.        ASSUMPTION OF RISK.Parent/Guardian understands that the Activities involve inherent and other risks, whether known or unknown, foreseeable or unforeseeable. These risks may include, without limitation: unpredictable animal behavior, including frightened, reactive, aggressive, or escaping animals; bites; scratches; puncture wounds; crushing injuries; facial injuries; scarring; infection; kicks; collisions, or being knocked down; zoonotic diseases and other illnesses; exposure to allergens, parasites, bodily fluids, cleaning agents, disinfectants, medications, or other substances; slips, trips, falls, uneven or wet surfaces; lifting, carrying, bending, repetitive motion, and other physical exertion; contact with cages, leashes, tools, sharp objects, vehicles or equipment; acts or omissions of other participants or members of the public; and risks associated with off-site activities or transportation, including boarding, exiting, loading, unloading, riding in, or operation of vehicles, when included in the Activities. Parent/Guardian knowingly accepts these risks in deciding to permit the Minor to participate and, to the fullest extent permitted by applicable law, assumes on behalf of the Minor the risks of injury, illness, death, or property damage arising from or relating to the Activities, including risks arising from the ordinary negligence of a Released Party.

3.        PARENT/GUARDIAN PERMISSION AND ACKNOWLEDGMENT.Parent/Guardian gives permission for the Minor to participate in the Activities and acknowledges that the nature and extent of the Minor's participation may depend on the Minor's age, size, maturity, experience, demonstrated ability, staff instructions, and Great Plains SPCA safety requirements. Parent/Guardian understands that Great Plains SPCA may restrict or end the Minor's participation in any Activity at any time for safety or operational reasons, and may change the Minor's permitted duties, animals, equipment, locations, or level of supervision at any time for safety or operational reasons.

4.        RELEASE OF ORDINARY NEGLIGENCE; STRICT AND STATUTORY LIABILITY. To the fullest extent permitted by the law applicable under the Governing Law; Venue; Severability section below, and in consideration of the Minor being permitted to participate in the Activities, Parent/Guardian knowingly and voluntarily releases, waives, covenants not to sue, and forever discharges the Released Parties from any and all claims, demands, causes of action, damages, losses, liabilities, and expenses, whether known or unknown, arising out of or relating to bodily injury, personal injury, illness, death, or property damage sustained by Parent/Guardian in connection with the Activities, including claims for medical expenses, loss of services, loss of consortium or companionship, or other derivative or consequential losses, and INCLUDING CLAIMS CAUSED IN WHOLE OR IN PART BY THE ORDINARY NEGLIGENCE OF A RELEASED PARTY and including ordinary negligent acts or omissions relating to the selection, intake, behavioral assessment or evaluation, classification, training, restraint, custody, supervision, handling, or placement of an animal; failure to warn of animal behavior or other hazards, participant or volunteer training or supervision; premises conditions, equipment, transportation or operation of a motor vehicle; or the conduct of the Activities. TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, PARTICIPANT ALSO RELEASES CLAIMS BASED ON STRICT OR STATUTORY LIABILITY ARISING FROM A RELEASED PARTY'S OWNERSHIP, POSSESSION, CUSTODY, CONTROL, OR HANDLING OF AN ANIMAL, INCLUDING, WHEN APPLICABLE, CLAIMS UNDER SECTION 273.036, RSMo. This Agreement does not apply to conduct or liability that applicable law does not permit to be released, including, to the extent applicable, gross negligence, wanton or reckless conduct, or willful or intentional misconduct.

5.        RELEASE ON BEHALF OF MINOR.To the fullest extent permitted by the applicable law under the Governing Law; Venue; Severability section below, Parent/Guardian, acting on behalf of the Minor, knowingly and voluntarily releases, waives, covenants not to sue, and forever discharges the Released Parties from any and all claims, demands, causes of action, damages, losses, liabilities, and expenses, whether known or unknown, arising out of or relating to bodily injury, personal injury, illness, death, or property damage sustained by the Minor in connection with the Activities, including claims for medical expenses, loss of services, loss of consortium or companionship, or other derivative or consequential losses, and INCLUDING CLAIMS CAUSED IN WHOLE OR IN PART BY THE ORDINARY NEGLIGENCE OF A RELEASED PARTY and including ordinary negligent acts or omissions relating to the selection, intake, behavioral assessment or evaluation, classification, training, restraint, custody, supervision, handling, or placement of an animal; failure to warn of animal behavior or other hazards, participant or volunteer training or supervision; premises conditions, equipment, transportation or operation of a motor vehicle; or the conduct of the Activities. TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, PARENT/GUARDIAN ALSO RELEASES CLAIMS BASED ON STRICT OR STATUTORY LIABILITY ARISING FROM A RELEASED PARTY'S OWNERSHIP, POSSESSION, CUSTODY, CONTROL, OR HANDLING OF AN ANIMAL, INCLUDING, WHEN APPLICABLE, CLAIMS UNDER SECTION 273.036, RSMo. This Agreement does not apply to conduct or liability that applicable law does not permit to be released, including, to the extent applicable, gross negligence, wanton or reckless conduct, or willful or intentional misconduct or to the extent applicable law does not permit a parent or legal guardian to prospectively waive or release that claim. This section is intended to have only the maximum effect permitted by applicable law. 

6.        SAFETY RULES AND SUPERVISION.Parent/Guardian agrees to instruct the Minor to follow all Great Plains SPCA safety rules, instructions, animal-handling procedures, staff directions, age or activity restrictions, and required use of safety equipment. Parent/Guardian and Minor will immediately report to Great Plains SPCA unsafe conditions, injuries, bites, scratches, or exposures. Parent/Guardian understands that a Minor may not handle an animal, use equipment, enter a restricted area, or perform an Activity unless authorized by Great Plains SPCA personnel. Parent/Guardian will not permit the Minor to participate when Parent/Guardian knows or reasonably should know that a physical, medical, behavioral, or other condition would make participation unsafe without disclosure to and approval by Great Plains SPCA. Parent/Guardian understands that Great Plains SPCA may require Parent/Guardian or another approved adult to remain present for particular Activities.

7.        EMERGENCY MEDICAL AUTHORIZATION; INSURANCE; EXPENSES.If Parent/Guardian cannot be reached or is unable to provide timely consent in an emergency, Parent/Guardian authorizes Great Plains SPCA to seek or arrange reasonably necessary emergency medical evaluation, first aid, ambulance transport, or other emergency care for the Minor. Great Plains SPCA assumes no obligation to provide or pay for such care. Parent/Guardian understands that Great Plains SPCA does not provide health, accident, disability, or property insurance for the Minor and agrees that Parent/Guardian is responsible for medical, ambulance, transportation, and personal-property expenses incurred for the Minor, except to the extent applicable law provides otherwise. Parent/Guardian understands that Great Plains SPCA may limit, suspend, or terminate the Minor’s participation at any time in its discretion for safety, animal-welfare, or operational reasons, without liability to Company for resulting lost time or expense except to the extent applicable law requires otherwise.

8.        MEDIA AND PUBLICITY CONSENT FOR MINOR.Parent/Guardian's selection (select consent preference at the bottom): If Parent/Guardian selects "I CONSENT," Parent/Guardian, for Parent/Guardian and as the Minor's parent or legal guardian, grants Great Plains SPCA perpetual, worldwide, royalty-free permission to photograph or record the Minor and to reproduce, edit, publish, display, and otherwise use the Minor's name, image, likeness, and voice for Great Plains SPCA's charitable, educational, fundraising, promotional, advertising, website, and social-media purposes in any media. Parent/Guardian waives any right to inspect or approve the finished use and any right of Parent/Guardian to compensation. This media consent is voluntary and is not a condition of participation. If neither option is initialed, Parent/Guardian will be deemed to have selected "I DO NOT CONSENT." Any later written request to withdraw consent will apply only to new recordings and new uses first initiated after Great Plains SPCA receives and reasonably processes the request; it will not require recall, removal, destruction, or cessation of materials already created, published, distributed, or committed for publication.

9.        INDEMNIFICATION.To the fullest extent permitted by the law applicable under the Governing Law; Venue; Severability section below, Parent/Guardian agrees to indemnify and hold harmless the Released Parties from third-party claims, losses, damages, liabilities, and reasonable attorneys' fees to the extent arising out of or caused by Parent/Guardian's or the Minor's negligence, intentional misconduct, material violation of Great Plains SPCA safety rules or instructions, Parent/Guardian's material violation of Great Plains SPCA safety rules or instructions, breach of this Agreement, or a materially false representation made by Parent/Guardian in connection with the Minor's participation. This indemnification does not require Parent/Guardian to indemnify any Released Party for that Released Party's own negligence or other fault.

10.      GOVERNING LAW; VENUE; SEVERABILITY. This Release is intended to be enforceable to the fullest extent permitted by the law applicable to the Activities. If the Activity giving rise to a claim principally occurred in Kansas, this Release and the claim shall be governed by Kansas law. If the Activity giving rise to a claim principally occurred in Missouri, this Release and the claim shall be governed by Missouri law. In either case, the governing state's substantive law applies without regard to its conflict-of-laws principles, except where applicable law requires otherwise. Any action or proceeding arising out of or relating to this Release or the Activities shall be brought exclusively in the District Court of Johnson County, Kansas or in the United States District Court for the District of Kansas located in Kansas City, Kansas, unless applicable law requires otherwise; each party consents to personal jurisdiction and venue exclusively in such courts to the fullest extent permitted by law. If any provision of this Release is held invalid or unenforceable under applicable law, it shall be severed or limited to the minimum extent necessary, and the remaining provisions shall remain in full force and effect.

11.      PARENT/GUARDIAN ACKNOWLEDGMENT AND AUTHORITY.Parent/Guardian acknowledges that Parent/Guardian has read this Agreement, understands it, has had the opportunity to ask questions and, if desired, consult counsel before signing, and signs knowingly and voluntarily. Parent/Guardian represents and warrants that Parent/Guardian is the Minor's parent or duly appointed legal guardian; has authority to authorize the Minor's participation and sign this Agreement independently or has obtained any consent required by an applicable custody order, guardianship order, or other legal restriction; and is not aware of any legal restriction that would prohibit or limit doing so.

  

BY SIGNING BELOW, PARENT/GUARDIAN UNDERSTANDS THAT THIS AGREEMENT RELEASES PARENT/GUARDIAN'S CLAIMS FOR THE ORDINARY NEGLIGENCE OF THE RELEASED PARTIES, TO THE FULLEST EXTENT PERMITTED BY LAW, CERTAIN STRICT OR STATUTORY LIABILITY CLAIMS ARISING FROM ANIMAL OWNERSHIP, POSSESSION, CUSTODY, CONTROL, OR HANDLING AND, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, RELEASES CLAIMS BELONGING TO THE MINOR. PARENT/GUARDIAN FURTHER ACKNOWLEDGES THAT THIS AGREEMENT APPLIES TO ALL ACTIVITIES DURING THE TERM OR, IF EARLIER, UNTIL THE MINOR'S EIGHTEENTH BIRTHDAY.

Media and Publicity Consent
I CONSENT
I DO NOT CONSENT
First Parent/Legal Guardian Name
First Name*
Last Name*
Phone*
First Parent/Legal Guardian's Age Acknowledgment*
First Parent/Legal Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Parent/Legal Guardian's Signature*
Second Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Second Parent/Legal Guardian Signature*
Third Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Third Parent/Legal Guardian Signature*
Fourth Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Fourth Parent/Legal Guardian Signature*
Fifth Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Fifth Parent/Legal Guardian Signature*
Sixth Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Sixth Parent/Legal Guardian Signature*
Seventh Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Seventh Parent/Legal Guardian Signature*
Eighth Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Eighth Parent/Legal Guardian Signature*
Ninth Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Ninth Parent/Legal Guardian Signature*
Tenth Parent/Legal Guardian Name
First Name*
Last Name*
Parent/Legal Guardian's Date of Birth*
Date of Birth
Tenth Parent/Legal Guardian Signature*
Parent or Guardian's Email Address
Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
MINOR PARTICIPANT SAFETY ACKNOWLEDGMENT (if age and maturity appropriate; not a contractual release): I understand that animals can behave unpredictably. I agree to follow Great Plains SPCA staff instructions and safety rules and to tell an adult or staff member immediately if I feel unsafe or am injured.
Emergency Contact Name *
Emergency Contact Number *
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*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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!