"Farm Fun for the Whole Family!"
Zebulon , Nc
Lazy Hound Farm
Summer Camp Waiver and Release of Liability Form
I hereby give my permission for my child(ren) to participate in the Lazy Hound Farm Camp. Participation in any program which involves physical activity exposes the camper to certain risks and dangers. Accidents and injuries are always a possibility, and it is impossible to foresee and protect the camper from all conceivable dangers. I hereby affirm that my child(ren) has/have no conditions that would make it unsafe for him/her/them to participate in the camps program(s) selected
I understand that the Farm may exclude my child(ren) from Summer Camp in the event that I or my child(ren) fail to abide by the health and safety protocols, disrupt, impede or interfere with the operations of the Summer Camp, or threaten the health, safety or welfare of other participants or Summer Camp staff, and that no refund of any fees will be made in such circumstances.
Medical Consent: I understand that the Farm will make every effort to contact me in the case of an emergency. I give my permission for the Farm arrange for and consent to any necessary medical treatment for my child(ren) while at the Farm, including onsite and offsite emergency care. I accept responsibility for the costs of all such medical treatment.
Photography Release: In consideration of child(ren)’s participation at Lazy Hound Farm Camp, and without any further consideration from the Farm, I hereby grant permission to the Farm to utilize my child(ren)’s appearance, performance or voice in all manner and media throughout the world for the purpose of promotion, reporting or publication. I understand that no royalty, fee or any other compensation of any kind shall become payable to me by reason of such release and use of any photograph.
By signing this Waiver and Release of Liability, with full appreciation of the risk involved, on my own behalf and on behalf of my child(ren), I hereby voluntarily release and forever discharge Lazy Hound Farm, its employees, agents, insurers and contractors from any and all legal or financial responsibility for any personal injury, disability, illness, damage, medical expense or death, arising from or related to my child(ren)’s participation in Summer Camp. I agree, for myself and my child(ren), not to make any type of legal or equitable claim on the Farm, or any of its employees, agents, insurers or contractors with respect to any injury I or my child(ren) may suffer, whether it arises through the negligence, omission, default or other action of anyone affiliated with the Farm, including other campers. I further agree that if any such claim is made, I will indemnify and defend the Farm with respect to any such claim, injury or damage.
Name of Camper(s)/Age(s): __________________________________________________________ Signature of Parent/Legal Guardian: ________________________________ Date: ______________
Parent/Legal Guardian Full Name: ____________________________________________________