CONSENT & CERTIFICATION
We, being the parents or legal guardians of the child named above (the "child"), do hereby consent to the participation of our child in the activities of Destiny Discovers Day Camp, at Destiny Christian Academy, located at 3401 Mayhew Road, Sacramento, CA 95827 on Thanksgiving Break 11/25-11/27 8:30am-4:00pm (Monday-Wednesday), Christmas Break 12/30-12/31 & 1/2-1/3 8:30am-4:00pm (No New Years Day), Winter Break 2/18-2/21 8:30am-4:00pm (Tuesday-Friday), Easter Break 4/14-4/17 8:30am-4:00pm(Monday-Thursday)
(916) 856-5600 ext. 8067.
ON CAMPUS ACTIVITIES including, but not limited to: sports, art, story time, extreme games, dancing, outdoor rec and bounce houses.
I / we hereby represent that child is in good health and in proper physical condition to participate in the above activities. Further, I / we certify that my child is physically able and adequately trained to participate in such events, including swimming. I / we understand and acknowledge the physical rigors associated with the activities and understand that participation involves risks and dangers which include, without limitation, the potential for serious bodily injury, permanent disability, paralysis and death; inaccessibility of medical care; dangers arising from adverse weather conditions; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of DCA; and other undefined harm or damage which may not be readily foreseeable, and other presently unknown risks and dangers ("Risks"). I / we understand that these risks may be caused in whole or in part by child’s own actions or inactions, the actions or inactions of others participating in the activity, and I / we hereby expressly authorize our child to participate in the above activities.
GENERAL RELEASE AND ASSUMPTION OF RISK
KNOWING THE RISKS DESCRIBED ABOVE, I / WE AGREE, ON BEHALF OF MYSELF AND MY CHILD, FAMILY, HEIRS, AND PERSONAL REPRESENTATIVES, TO ASSUME ALL THE RISKS AND RESPONSIBILITIES SURROUNDING MY CHILD’S PARTICIPATION IN THE ABOVE-DESCRIBED ACTIVITIES, BOTH KNOWN AND UNKNOWN. TO THE MAXIMUM EXTENT ALLOWED BY LAW, I / WE RELEASE, HOLD HARMLESS, AND AGREE TO INDEMNIFY DESTINY CHRISTIAN ACADEMY, AND ITS AFFILIATED MINISTRIES AND THEIR OFFICERS, DIRECTORS, EMPLOYEES, VOLUNTEERS, AND AGENTS, FROM AND AGAINST ANY PRESENT OR FUTURE CLAIMS, LOSSES, LIABILITIES, COSTS AND EXPENSES FOR INJURY TO PERSON OR PROPERTY, OR FOR ANY OTHER DAMAGE, WHICH MY CHILD MAY SUFFER, OR FOR WHICH MY CHILD MAY BE LIABLE TO ANY OTHER PERSON, RELATED TO MY CHILD’S PARTICIPATING IN SAID ACVTIVITIES (INCLUDING PERIODS IN TRANSIT TO OR FROM DESTINATIONS), RESULTING FROM ANY CAUSE, INCLUDING BUT NOT LIMITED TO NEGLIGENCE ON MY CHILD’S PART OR ON THE PART OF ANY OF THE RELEASED PARTIES; PROVIDED THAT THIS RELEASE OF LIABILITY SHALL NOT APPLY TO GROSS NEGLIGENCE OR WILLFUL OR WANTON MISCONDUCT.
1. I / We expressly waive any defense to the enforcement of any provision of this commitment arising from a claim of lack of consideration and warrant that this commitment constitutes a legal, valid, and binding obligation upon me / us enforceable against me/us in accordance with its terms.
2. Invalidation of any one or more of the provisions of this Agreement shall in no way affect any of the other provisions hereof, which shall remain in full force and effect.
3. I / We expressly agree that this assumption of risk, release, and indemnity agreement is intended to be as broad and inclusive as permitted by law. I/We further state that I / WE HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND ITS CONTENTS, AND I/WE VOLUNTARILY SIGN THIS AGREEMENT AS MY/OUR OWN FREE ACT.
4. I / We understand and agree that no oral or written representations can or will alter the contents of this document. This Agreement shall be governed and construed in accordance with the laws of the State of California, excluding its choice of law rules, and all claims relating to or arising out of this Agreement, including claims for injuries or wrongful death in any way related to the above-described activities, shall likewise be governed by the laws of the State of California, excluding its choice of law rules.
5. I / We attest to the truthfulness, accuracy, and validity of the foregoing statements.
MEDICAL TREATMENT AUTHORIZATION
I /we understand that I / we will be notified in the case of a medical emergency involving my child. However, in the event that I / we, cannot be reached, I / we authorize the calling of a doctor and the providing of necessary medical services in the event that my child is injured or becomes ill. I / we authorize any one or more of the following persons to make emergency medical care decisions on behalf of my child, if required by law or a health care provider.
I / we understand that DCA, or any of their agents, employees, or volunteers, will not be responsible for medical expenses incurred on the basis of this authorization.
I / we agree to notify DCA in the event of any health changes which would restrict my child's participation in any activities. I / we also understand that the adult church / school representatives reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.
