Sample Child Guardian Consent Form, Medical Authorization For Minors & Minors' Consent To Participate And Hold Harmless Agreement (Page 3 of 4) in pdf

The Society for Creative Anachronism, Inc.

P.O. Box 360789 Ž Milpitas, California 95036-0789 Ž Tel (408) 263-9305 Ž Fax (408) 263-0641

MINOR'S CONSENT TO PARTICIPATE AND HOLD HARMLESS AGREEMENT

(hereafter referred to as “the minor”)

Print Minor's Legal Name

does hereby state that the minor wishes to participate in activities sponsored by the international organization known as the

Society for Creative Anachronism, Inc., a California not-for-profit corporation (hereafter “SCA”).

The SCA has rules which govern and may restrict the activities in which the minor can participate. These rules

include, but are not limited to: Corpora, the By-laws, the various kingdom laws and the Rules for combat related activities.

The SCA makes no representations or claims as to the condition or safety of the land, structures or surroundings,

whether or not owned, leased, operated or maintained by the SCA.

The minor's parent(s) or guardian(s) understand that all activities are VOLUNTARY and that the minor does not have

to participate. It is understood that these activities are potentially dangerous or harmful to the minor's person or property, and

that by participating, the minor's parent(s) or guardian(s) voluntarily accepts and assumes the risk of injury to the minor or

damage to the minor's property.

It is understood that the SCA does NOT provide any insurance coverage for the minor's person or property; and

minor's parent(s) or guardian(s) acknowledge that they are responsible for the minor's safety and the minor's own health care

needs, and for the protection of the minor's property.

In exchange for allowing the minor to participate in these SCA activities and events, the minor by and through the

undersigned, agrees to release from liability, agrees to indemnify, and hold harmless the SCA, and any SCA agent, officer,

or SCA employee acting within the scope of their duties, for any injury to the minor's person or damage to the minor's

property.

This Release shall be binding upon the minor, the parent(s) or guardian(s), any successors in interest, and/or any

person(s) suing on the minor's behalf.

The minor's parent(s) or guardian(s) understand that this document is complete unto itself and that any oral promises

or representations made to them concerning this document and/or its terms are not binding upon the SCA, its officers, agents

and/or employees.

PARENT OR LEGAL GUARDIAN MUST SIGN BELOW:

I, the undersigned, state that I am the parent or legal guardian of the minor whose name appears above. I understand that the

above terms and conditions apply to said minor and to myself. I further understand that said minor cannot participate under

ANY circumstances in armored martial arts, any combat-related activities, combat-archery, or fencing without parental

consent where such participation is allowed by kingdom law. The minor will not be able to participate in any SCA activities

without entering into this agreement. This document is binding on myself, the said minor and any person suing on behalf of

said minor.

Minor's Name (PRINT):

Birthdate of minor:

Home State of minor:

Legal Name (PRINT):

Parent/Guardian

Legal Name (SIGN):

Date:

Parent/Guardian

Sample Child Guardian Consent Form, Medical Authorization For Minors & Minors' Consent To Participate And Hold Harmless Agreement Page 3