Voluntary Consent And Release Form - Town Of Easton printable pdf download

Town of Easton

VOLUNTARY CONSENT AND RELEASE FORM

(Adults Age 18 or Over)

I, _______________________________________________do hereby consent to participation in

the __________________________________________________offered by the Town of Easton.

I agree and covenant to forever release, acquit, discharge and hold harmless the Town of Easton

and all their employees, agents, board members, volunteers and any and all individuals and

organizations assisting or participating in the above-described voluntary athletic or recreation

programs/activities of the Town of Easton from any and all claims of any nature whatsoever,

rights of action and causes of action that may have arisen in the past, or may arise in the future,

directly or indirectly, from any and all known or unknown personal injuries or property damage

resulting from or in any way growing out of, directly or indirectly my voluntary participation in

the Town of Easton’s voluntary athletic or recreation programs/activities.

I hereby forever, release, indemnify, defend, and hold harmless the Town of Easton against any

and all legal claims of any nature or kind whatsoever and proceedings of any description that

may have been asserted in the past, or may be asserted in the future, directly or indirectly, arising

from personal injuries or property damage resulting from my voluntary participation in the

above-described activities of the Town of Easton voluntary athletic or recreation

programs/activities.

I further affirm that I have read this Consent and Release Form and that I understand the contents

of this Form. I understand that my participation in the above referenced athletic or recreation

programs/activities is voluntary and that I am free to choose not to participate in said programs.

By signing this Form, I affirm that I have decided to participate in the above-described activities

of the Town of Easton athletic or recreation programs/activities with full knowledge that the

Town of Easton will not be liable to anyone for personal injuries and property damage I may

suffer as a result of my voluntary participation in the above-described athletic or recreation

programs/activities.

I further authorize the Town of Easton to transport me to a hospital or to place me in the care of

an ambulance attendant(s) for transportation to the hospital and give my consent for emergency

medical care by a licensed Doctor of Medicine or Dentistry as may be warranted to preserve my

wellbeing.

Signature of Student:

Dated:

Medical Insurance Policy No:

Voluntary Consent And Release Form - Town Of Easton