top of page

Village Education Centers LLC


Student's Birthday
Month
Day
Year
Student's address

LIABILITY WAIVER, CONSENT, RELEASE, HOLD HARMLESS, AND INDEMNIFICATION AGREEMENT

As parent or legal guardian of the child(ren) whose name(s) is/are set forth above (who is/are referred to herein as the “Participant(s)") and in consideration of the Participant(s) being permitted to participate in the activities at Village Education Centers LLC., the Participant(s) and I agree as follows:

I agree to place Participant(s) in Village Education Centers LLC Drop Off program. I understand that the participation of activities at Village Education Centers LLC entail the risk of serious bodily injury to the Participant(s). This Waiver covers risks of death, serious injury, and property loss whether arising from (a) negligence or carelessness on the part of the persons or entities being released and other participants, or (b) dangerous or defective equipment. Notwithstanding these risks and other hazards that may be foreseeable and unforeseeable but not specifically identified herein, I, for myself and the Participant(s) and our respective heirs, personal representatives and assigns, understand, acknowledge, and expressly and voluntarily assume all risks and full responsibility for any injury arising out of or related to the activities. The Participant(s) is/are physically fit and may participate in activities at Village Education Centers LLC and has not been advised to the contrary by a qualified medical professional.

I, for myself and the Participant(s) and our respective heirs, personal representatives and assigns, do hereby release, discharge and agree not to sue Village Education Centers LLC and its managers, members, employees and/or other agents, for any injury to or death of the Participant(s) arising, directly or indirectly, from participation in activities. This release, discharge and covenant not to sue shall relate to any and all claims or legal rights now existing or arising in the future, including claims and legal rights arising out of any negligence of Village Education Centers LLC and/or its managers, members, employees and/or other agents and any other breach of a legal duty arising out of common law, statute, contract or otherwise.

I agree to indemnify and hold Village Education Centers LLC and its managers, members, employees and/or other agents harmless from, without limitation, any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees and costs, incurred due to claims brought by any third party as a result of or arising out of the Participant’s involvement in activities and to reimburse Village Education Centers LLC for any such costs, expenses and fees as they are incurred.

I agree that my execution of this Waiver on the initial visit for the Participant(s) will authorize Village Education Centers LLC to enter this Waiver into its database and use it as a continuous, multi-use waiver for the Participant’s ongoing participation in activities. I hereby expressly authorize Village Education Centers LLC to use this Waiver as a multi-use waiver until such time as I revoke it in writing.

In the event of an emergency or health concern, Village Education Centers LLC has my permission to administer first aid, contact our pediatrician, or obtain emergency medical treatment for the Participant(s). I agree to pay all expenses incurred due to an emergency involving the Participant(s)

I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I and the Participant(s) may be exposed to or infected by COVID-19 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 Village Education Centers LLC may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Village Education Centers LLC employees and other participants.

I hereby certify that I am the parent or legal guardian of the Participant(s) whose name(s) appears above, and I have authority to waive rights on behalf of the minor Participant(s). I have read and I understand all of the provisions of this document and the risks of activities. I acknowledge that I have read and understand the terms of this document and I am freely and voluntarily signing this document.

I hereby grant the Village Education Centers LLC permission to use the Participant(s)'s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.

Stay connected,

subscribe to our newsletter!

Thank you for subscribing!

Located at 31542 Railroad Canyon Rd. Suite 8 Canyon Lake, Ca 92587

bottom of page