PARENT’S AND PARTICIPANT’S INFORMED CONSENT, AUTHORIZATION, AND RELEASE

(This is a legal document. Read carefully before checking box.)

To the fullest extent permitted by law, in consideration of the person noted below being allowed to participate, with each and all person/s acknowledging the opportunity to ask questions, be aware and receive full information, understanding and give voluntary consent regarding the potential risks in any physical or other activity/ies involved generally and particularly and inherently in parks and/or recreation programs, including those inherent related to a trip or travel, the undersigned individual/s VOLUNTARILY AND UNCONDITIONALLY on behalf of the undersigned and as well as by the participant personally, if the participant is at least 18 years of age, and for successors in interest AGREE that the undersigned:

•  ASSUMES ALL RISKS, and
•  FOREVER WAIVE/S AND RELEASE/S the City of Staunton, its departments and agencies, officials, employees, agents, representatives and volunteers (individually and collectively the “City”) from any claims and liability of any nature whatsoever, for ANY KIND OF PERSONAL INJURY, ILLNESS, DEATH, EXPENSE, COST, AND DAMAGES except those not subject to waiver or release under the law, and
• FOREVER WAIVE/S AND RELEASE/S ALL PROPERTY DAMAGE, LOSS AND/OR DAMAGES that may relate, directly or indirectly, to the program and activity/ies connected with the City in any aspect of it/them at any time and at any place whether before, during or afterwards, and
• FOREVER AUTHORIZE/S the City to seek and obtain CARE, MEDICAL ATTENTION ANDTREATMENT of any kind for the participant whether the treatment occurs without knowledge of the quality of care or treatment provider or facility, and ACCEPTS FULL RESPONSIBILITY AND LIABILITY FOR ANY CHARGES OR EXPENSES AND/OR COSTS incurred or related to such care and treatment, including EXPENSE related to transportation or early return home, whether or not it is covered by any insurance policy, plan or program or agreement of any kind.

* Pursuant to the City’s Travel Policy, which is incorporated by reference and may be changed at any time, once payment is made for the program or activity, including any required deposit or payment in full, there is NO REFUND unless an authorized City person cancels the trip entirely, with such a decision being within the sole discretion of the City. TIME IS OF THE ESSENCE in making any payment by the designated time. The failure to make timely payment strictly as specified completely waives the opportunity to participate in the program or activity without further notice.

Each provision of this document is separable, and each such provision, including each clause, stands on its own. The City does not waive and expressly preserves any immunity of any kind as allowed by law.

Overnight Travel Policy

All trips are to be paid in full when signing up unless another specific option is available where a minimum of 50% deposit is required for each person. Once a payment is received from a patron they are considered to have an official spot on the trip if there is available space. All patrons understand that there is a no refund policy in effect unless the Recreation department decides to cancel a trip. It is at the Recreation department’s discretion on the cancellation of trips and most will be done in a timely manner. In some extreme cases such as death or serious medical conditions a refund may be available to a patron of a trip minus any expense the Recreation department may incur. Name changing fees may occur on trips involving plane flights. In cases regarding deposits; if the balance isn’t paid by the deadline, patron may lose full deposit and spot on the trip.

Before registration form is complete, you will be required to sign and date on the reverse side of this form that you have read, understand and accept this addition to our registration process. If registering for a trip, please list EMERGENCY CONTACT (name, address, and phone number).

Program and Day Trip Refund Policy

In the case of a cancellation by Parks and Recreation staff, the refund will be issued in the form of a check through the City’s Finance Department. Check will be mailed to the address on file. Please allow a minimum of 2-3 weeks for refunds by check. No refunds or credits will be given for any program or activity sessions missed by the participant. If adequate advance notice is provided, we will refund the full amount of the program less any non-recoverable expenses, as listed below. If there is a waiting list and we are able to fill your spot on a day-trip or in a program, you will receive a full refund. General Program or One-Day Trip: Full refund prior to the registration deadline, less any non-recoverable expenses (pre-paid meals, lodging, tickets, etc.) If adequate advance notice prior to the registration deadline is not given, and your space cannot be filled, all fees are forfeited.

The contact will be automatically added to the class as a registrant if someone drops out from a full class.