Family Day Registration

By signing this form, I am giving consent and permission for On Belay staff, volunteers, representatives, or contractors to provide medical care to my child, to transport my child to a medical facility, or seek the aid of emergency medical services as deemed appropriate. I further authorize On Belay staff, volunteers, representatives, or contractors to render whatever treatment they consider necessary for my child’s health, and I agree to pay all costs associated with that care and transportation. In the event I cannot be reached, I give permission for the administration of emergency medical and/or surgical treatment deemed necessary by a local physician or emergency personnel.

1. In consideration for receiving permission for me and/or my child to participate in all On Belay programs during the current calendar year. I hereby release, waive, discharge and covenant not to sue On Belay Inc., its ocers, servants, agents, volunteers, contractors, and employees (hereinafter referred to as the "Releasees") from any and all liability, claims, demands, actions and causes of action whatsoever, arising out of or relating to any loss, damage or injury, including death, that may be sustained by me and/or my Child, or to any property belonging to me or my Child, whether caused by the negligence of the Releasees, or otherwise, while participating in the Programs, or while in, on or upon the premises where the Programs are being conducted, while in transit to or from the premises, or in any place or places connected with the Program. 2. I am fully aware of risks and hazards connected with being on the premises and participating in the Programs, and I am fully aware that there may be risks and hazards unknown to me connected with being on the premises and participating in the Programs, and I hereby elect to voluntarily participate and/or have my Child participate in the Programs, to enter upon the above named premises and engage in activities knowing that conditions may be hazardous, or may become hazardous or dangerous to me and/or my Child and the property of either of us. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained by me or my Child, or any loss or damage to property owned by me or my Child, as a result of either of our participations in the Programs, whether caused by the negligence of Releasees or otherwise except for willful misconduct. 3. I further hereby agree to indemnify and save and hold harmless the Releasees and each of them, from any loss, liability, damage or costs they may incur due to my or my Child’s participation in the Programs, whether caused by the negligence of any or all of the Releasees, or otherwise except for willful misconduct. 4. It is my express intent that this Release shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative and those of my Child, if I or my Child are deceased, and shall be deemed as a Release, Waiver, Discharge and Covenant Not to Sue the above named Releasees. In signing this release, I acknowledge and represent that: I have read the foregoing release, understand it, and sign it voluntarily as my own free act and deed; No oral representations or statements, apart from the foregoing written agreement, have been made; I am at least eighteen years of age and fully competent; and have the legal capacity to act on behalf of my Child; I execute this Release for full, adequate and complete consideration fully intending to be bound by same.

Full width 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 attending an On Belay 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 at an On Belay program may result from the actions, omissions, or negligence of myself and others, including, but not limited to, On Belay staff, 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 attendance at an On Belay program. On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless On Belay, its employees, agents, 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 On Belay, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any On Belay programs.