Hold Harmless Agreement Template


_____________________________ COUNTY )
I, _______________________________________________, as the parent or guardian for
(Parent’s Name)
________________________________________________, a minor child who is in my care and
(Child’s Name)
custody, do hereby grant my permission for my child to attend a program or event at YMCA Camp
Chandler. I fully understand the nature of camping and recreational activities associated with the
use of the camp facilities and/or programs includes an inherent risk of danger, which may result in
personal injury or harm to my child. I understand that my child will be under adult supervision at all
times but, notwithstanding any level or degree of supervision, that accidents may occur which may
result in physical injury or harm to my child. It is with the full understanding of the risks associated
with these types of activities that I grant permission for my child to participate in the program to be
conducted at YMCA Camp Chandler, and I agree to indemnify and hold harmless YMCA Camp
Chandler, the Montgomery Metro YMCA, its staff, directors, employees, agents and/or
representatives from any claim for any injury or damage which may result from my child’s
attendance and participation in the program conducted on camp property. Permission is granted
for my child to participate and I understand that by signing this form I am voluntarily and knowingly
accepting responsibility for my child’s participation in the activity or program to be conducted at
YMCA Camp Chandler. I also grant permission for pictures and images of my child to be taken
while participating in activities and used for YMCA promotional purposes.
Dated this ____________
day of _____________________, 20 ____________.
Parent’s Signature:_________________________________________________


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