Franklin Pierce University Camp/Clinic

Informed Consent, Voluntary Waiver, Release of Liability & Assumption of Risks
PLEASE READ THIS DOCUMENT BEFORE SIGNING. THIS IS A LEGALLY BINDING DOCUMENT. THIS FULLY SIGNED
FORM MUST BE SUBMITTED BY A PARENT OR LEGAL GAURDIAN BEFORE ANY CHILD IS ALLOWED TO PARTICIPATE
IN THE ABOVE REFRENCED CAMP/CLINIC.
I, the undersigned, wish for my child (hereafter “Child”) to participate in the above referenced camp/clinic
(hereafter “Camp/Clinic”), in consideration for my Child’s participation, I hereby agree as follows: I acknowledge,
understand and appreciate that as part of my Child’s participation in the Camp/Clinic there are dangers, hazards
and inherent risks to which my Child may be exposed, including the risk of serious physical injury, temporary or
permanent disability, and death, as well as economic and property loss. I further realize that participating in the
Camp/Clinic may involve risk and dangers, both known and unknown, and have elected to allow my Child take part
in the Camp/Clinic. Therefore I, on behalf of my Child, voluntarily accept and assume all risk of injury, loss of life or
damage to property arising out of training, preparing, participating and traveling to and from the Camp/Clinic. I,
on behalf of my Child, hereby release Franklin Pierce University, its Board of Trustees, Administration, Faculty,
Staff, Student Leaders, the camp/clinic staff, and all other officers, directors, employees, volunteers and agents
(hereafter “Franklin Pierce”) from any and all liability as to any right of action that may accrue to my heirs or
representatives for any injury to my Child or loss that my Child may suffer while training, preparing, participating
and/or traveling to or from the Camp/Clinic. This agreement is binding on my heirs and assigns. I, on behalf of my
Child, furthermore release, indemnify and hold harmless Franklin Pierce from and against any and all liability,
actions, debts, claims and demands of every kind whatsoever, specifically including, but not limited to, any claim
for negligence or negligent acts or omissions and any present or future claim, loss or liability for injury to person or
property that my child may suffer, for which my Child may be liable to any other person, that may or does arise
out of my Child’s participation in the Camp/Clinic. I understand that Franklin Pierce accepts no responsibility for
my Child’s personal property. In the event of an accident or serious illness, I hereby authorize representatives of
Franklin Pierce to obtain medical treatment for my Child on my behalf. I hereby hold harmless and agree to
indemnify Franklin Pierce from any claims, causes of action, damages and/or liabilities, arising out of or resulting
from said medical treatment. I further agree to accept full responsibility for any and all expenses, including
medical expenses that may that may derive from any injuries to my Child that may occur during his/her
participation in the Camp/Clinic. This RELEASE shall be governed by and construed under the laws of New
Hampshire, I agree that any legal action or proceeding relating to this RELEASE, or arising out of any injury, death,
damage or loss as a result of my Child’s participation in any part of the Camp/Clinic, shall be brought only in
Cheshire County, New Hampshire. This RELEASE contains the entire agreement between the parties to this
agreement and the terms of this RELEASE are contractual and not a mere recital. The information I have provided
is disclosed accurately and truthfully. I have been given ample opportunity to read this document and I
understand and agree to all of its terms and conditions. I understand that I am giving up substantial rights
(including my right to sue), and acknowledge that I am signing this document freely and voluntarily, and intend by
my signature to provide a complete and unconditional release of all liability to the greatest extent allowed by law.
My signature on this document is intended to not only bind not only myself and my Child but also the successors,
heirs, representatives, administrators, and assigns of myself and my Child.