Release of Liability and Assumption of Risk

Birthday Child's Name*

Date*

Parent's Name*

First Last

Emergency Contact number*

Email*

Notes

I hereby acknowledge that I have voluntarily allowed my child to participate in activities to be conducted by Montclair Learning Center. On behalf of myself, my heirs, assigns and next of kin, I hereby WAIVE AND RELEASE, indemnify, hold harmless and forever Montclair Learning Center, its owners, agents, staff, volunteers, successors and assigns, of any and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I ever had or may have, arising from or in any way related to my participation, my child’s participation, or my family’s participation in any of the events or activities conducted by, on the premises of, or for the benefit of Montclair Learning Center provided that this waiver of liability does not apply to any acts of gross negligence, or intentional willful or wanton misconduct. By signing this waiver, I assume any risk and take full responsibility for any claims of personal injury, death, or damage to personal property associated with Montclair Learning Center. I authorize that my child may be photographed or videotaped in conjunction with the activities, and assign to Montclair Learning Center all rights to such works. The provision of this WAIVER AND RELEASE will continue in full force and effect even after the termination of the activities conducted by, on the premises of, or on behalf of Montclair Learning Center whether by agreement, by operation of law, or otherwise. I have read, understand and fully agree to the terms of this WAIVER AND RELEASE. I understand and confirm that by signing this WAIVER AND RELEASE I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. I am 18 years of age or older and mentally competent to enter into this waiver.*

I Agree

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