ACKNOWLEDGEMENT OF RISK OF ACTIVITIES
As a condition of and in consideration of being permitted to enroll your child in the Citrus Heights Police Activities League and sponsored programs, you are requested to read this form carefully and indicate your agreement by dating and signing the form below.
I acknowledge, realize, and am aware that my child will be participating in a variety of activities. I understand that there are elements
of risks in any activity associated with participation. These risks include, but are not limited to: falling, tripping, being hit by another
child, getting injured in a vehicle which is providing transportation, etc. I also acknowledge and understand that although Citrus Heights PAL staff and volunteers may be present; those persons are not always able to prevent the risks that have been described above. Therefore, I agree as follows:
1. Release: As a condition of and in consideration of being permitted by Citrus Heights PAL to participate in the activities provided, I
for myself and/or minor children for whom I am a parent/legal guardian or otherwise responsible, any heirs, personal representatives, or assigns do hereby release, discharge, and covenant not to sue the Citrus Heights PAL, its employees, principles, directors, officers, agents, volunteers, or anyone affiliated with the Citrus Heights PAL and each/every landowner, municipal and/or governmental agency upon whose property an activity is conducted, from all liability and waive any claim for damages arising from any cause whatsoever, except that which is the result of gross negligence.
2. Express Assumption of Risk and Responsibility: In recognition of the inherent risk of the activity which I and/or any minor children for which I am responsible, will engage in, I confirm that my child is physically and mentally capable of participating in this activity and using the equipment. My child is participating willingly and voluntarily. I assume full responsibility for personal injury, accidents
and/or illness, including, but not limited to, sprains, torn muscles, bites, wounds, scrapes, abrasions and/or contusions; head, neck and/or spinal injuries, bites or attacks by animals or insects, allergic reactions, shock, paralysis, coma or death, and any related expenses that are related to my child. I assume all responsibility for damage to or loss of my/our personal property as a result of any
accident that may occur.
3. Hold Harmless/Assumption of Risk: I agree that I/we will indemnify and hold harmless the Citrus Heights PAL, the City of Citrus Heights and the County of Sacramento, and any affiliated organization, its representatives, its employees, principles, directors, officers, agents, volunteers, or anyone affiliated with the City of Citrus Heights and the County of Sacramento and each and every landowner, municipal and/or governmental agency upon whose property and activity is conducted, from any loss, all liability and waive any claim
for damages or costs arising for any cause whatsoever related to my child’s participation, except that which is the result of gross
negligence. I further expressly agree that this assumption of risk, release and indemnity agreement is intended to be as broad and inclusive as is permitted by the laws of the State of California and if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I also agree to take any, all and full responsibility for any interactions that occur relating to an employee of the City/County who is in any fashion associated with or having contact with my child outside the specific hours of the program. I have read the foregoing Acknowledgment of Risk, Assumption of Risk, Assumption of Risk and Responsibility, Release of Liability and Hold Harmless Agreement. I understand that by signing this document, I am waiting valuable legal rights. I do so voluntarily. I do so with full understanding that the Citrus Heights PAL and the City of Citrus Heights are not to be held responsible, whatsoever, or at all for injuries that may occur to me and/or any child of mind except that which is conclusively determined to be the result of gross negligence.
BY SIGNING THIS AS A PARENT OR GUARDIAN, I HEREBY AGREE THAT I AM DULY AUTHORIZED TO DO SO ON BEHALF OF MYSELF AND
ON BEHALF OF ANY OTHER PARENT OR GUARDIAN TO THE PARTICIPATING CHILD.