Ormond Beach Leisure Services

BEHAVIOR POLICY ACKNOWLEDGEMENT

While every effort will be made by staff to work with my child’s behavior, should any behavior threaten the safety of staff or other participants, I understand my child can be expelled, at the discretion of staff, from participating in any Leisure Services programs or activities.

 TERMS AND CONDITIONS OF PARTICIPATION-READ CAREFULLY BEFORE SIGNING

In consideration of my minor child, minor children or ward listed above (“child”) being permitted to participate in the recreational program (“Recreational Program”) I, the undersigned, hereby, after reading the Authorization, Release, Waiver and Notice completely and carefully, acknowledge that participation in the Recreational Program by my child is entirely voluntary, and understand and agree as follows: 

PHYSICAL CONDITION/MEDICAL AUTHORIZATION

 I hereby certify that my child is physically fit for participation in the Recreational Program and has the skill level required in connection with the Recreational Program, and I have not been advised otherwise.  I hereby give permission for my child to receive any necessary medical treatment if injured during the Recreational Program.  

PHOTO RELEASE

The City of Ormond Beach has my permission to use/take a photograph of my child for the use of publicity of the above program without compensation.  I hereby waive any claim that may arise or be connected to the use/taking of my child’s photograph. 

PERMISSION TO PARTICIPATE, RELEASE AND WAIVER OF LIABILITY

I the undersigned, as the parent or legal guardian of my child, do hereby give my full consent and approval for my child to participate in the Recreational Program.  I understand that there are certain risks of damages and injuries, including death, inherent in the Recreational Programs, as well as in any transportation in City owned or non-owned vehicles that may be part of the program and in other related activities incidental to my child’s participation, and I am willing to assume these risks on behalf of myself and my child.  These risks include, but are not limited to, those hazards associated with weather conditions, travel, playing conditions, equipment, and other participants. 

Further, I understand that there is inherent risk in the Recreational Program and that inherent risk means those dangers or conditions, known or unknown, which are characteristic of, intrinsic to, or an integral part of the activity and which are not eliminated even if the activity provider acts with due care and includes failure by the activity coordinator to warn me or my child of an inherent risk or the risk that the participant or another participant in the activity may act in a negligent or intentional manner and contribute to the injury or death of my child. 

 I understand that the Recreational Program may actually be organized, directed and presented by an individual performing those duties as an independent contractor or specialist using City property.  I further understand that the Authorization, Release, Waiver, and Notice apply to all City of Ormond Beach programs that my child participates in. 

 I agree that in consideration for my child’s participation in the Recreational Programs that I shall hold harmless and fully indemnify and defend the City of Ormond Beach, its employees, affiliates and/or agents (Released Parties) from any and all causes of action, claims, damages, costs including but not limited to attorney’s fees and costs, which may arise from the inherent risks that are a part of these activities.  I hereby waive, release, discharge and agree not to sue the Released Parties for any and all causes of actions, claims or damages, injuries or death arising out of the inherent risks of these activities.  I agree that in consideration for my child being permitted to participate in the activity, I assume full responsibility for any loss of property, accident, bodily injury, or death as a result of my child’s participation in this activity.

 Relating to Coronavirus/COVID-19

COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to, or infected by COVID-19 by participating in this program, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 in this program may result from the actions, omissions, or negligence of myself and others, including, but not limited to, City of Ormond Beach employees, volunteers, and program participants and their families.

 I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself including, but not limited to, personal injury, disability, and death, illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s participation in this program. On my behalf, and on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless City of Ormond Beach, its employees, agents, volunteers and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of City of Ormond Beach, its employees, agents, volunteers, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any City of Ormond Beach program. I also understand by not signing this release, my child(ren) will not be able to participate in this program.

 NOTICE TO THE MINOR CHILD'S NATURAL PARENT OR GUARDIAN(S)

READ THIS FORM COMPLETELY AND CAREFULLY. You are agreeing to let your minor child engage in a potentially dangerous activity.  You are agreeing that, even if the City of Ormond Beach, its employees, affiliates, and/or agents, use reasonable care in providing this activity, there is a chance your child may be seriously injured or killed by participating in this activity because there are certain dangers inherent in the activity which cannot be avoided or eliminated.  By signing this form, you are giving up your child’s right and your right to recover from the City of Ormond Beach, its employees, affiliates, and/or agents in a lawsuit for any personal injury, including death, to your child or any property damage that results from risks that are a natural part of the activity.  You have the right to refuse to sign this form, and the City of Ormond Beach, its employees, affiliates, and/or agents, have the right to refuse to let your child participate if you do not sign this form.  FLA. STAT. § 744.301 (2016). 

By signing below, I certify that: (1) I have fully and completely read and understand the above; (2) I am 18 years of age or older, (3) I am the legal guardian of the child identified above, (4) the information set forth above pertaining to my child is true and complete, (5) I consent and agree to all of the foregoing  on behalf of myself and my child identified above, (6) I am competent, of sound mind, and freely, voluntarily, and knowingly signed my name hereto after having read the Authorization, Release, Waiver and Notice, (7)  No oral representations, statements, or inducements have been made, (8) I agree that the Release and Waiver are intended to be as broad and inclusive as is permitted by the laws of Florida and that if any portion is held invalid, I agree that the balance shall notwithstanding, continue in full legal force and effect,  and (9) agree that my child and I shall abide by all rules and regulations adopted by the Leisure Services Department and all City ordinances.

The contact will be automatically added to the class as a registrant if someone drops out from a full class.