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Jersey Cares Day Youth Waiver 


 

 

________________________________________________________________________________________________________________________________________________________________________________

All participants in Jersey Cares Day must be 10 years of age and over and must agree to this waiver, regardless of age.  If you are under 18 years of age, a parent or legal

guardian must also sign this waiver.

 

 

In consideration of the acceptance of my voluntary participation in Jersey Cares Day 2014, I (including my heirs, legal representatives), on behalf of__________________________________________________________, a minor over whom I am authorized to exercise legal responsibility, do absolve, release and waive all claims against Jersey Cares, Inc., its members, employees, officers, directors, agents and anyone else involved directly or indirectly with the event (including sponsors, other participating organizations, etc.) from any and all liability resulting from the above minor's attendance at or participation in the event. 

 

The event spans a wide variety of different locations, causes, responsibilities, and tasks. Some of these tasks are physically demanding, or may be in economically depressed and/or high-crime areas. The tasks may involve activity which, if not completed properly or responsibly, could result in serious injury. Jersey Cares makes every effort to ensure that all minors are properly supervised at all times, and that all safety precautions are followed at all times. In spite of its efforts it is possible that an injury or accident could occur.

 

I, on behalf of the person written above, accept and assume any and all risks resulting from attendance at and participation in the project, and attest that I am satisfied with the research I have done, the questions I have asked, and the information Jersey Cares and its members, employees, officers, directors, agents, and others have provided to me about any individual project. By signing this waiver form, I am stating that the minor listed above is physically and psychologically fit and prepared for the event in which s/he is participating, and if at any time I have doubts about whether this is true, I agree to remove the minor from participation immediately.

 

I agree to indemnity, defend and hold harmless Jersey Cares, Inc., its members, employees, officers, directors, agents and anyone else involved directly or indirectly with the event from any and all claims, demands, expenses and liability which is caused by me or the minor, including but not limited to compensatory damages for personal injury or property damage, and attorney's fees incurred in defending any such claim.

 

I grant full permission to Jersey Cares, Inc. and anyone else involved directly or indirectly with the event to use photographs and video and sound records of me and/or the minor named above and quotes from me and/or the minor named above  in legitimate accounts and promotions of this event.

 

I give my child permission to participate in this event.

 

 

_____________________________________________________________             ________________________________

Signature                                                                                                                                  Date

 

 

Volunteer Name:__________________________________________________________________   

 

Project Name:_____________________________________________________________________

 

Address:_______________________________________________________________________

 

City, State, Zip:____________________________               Minor's Date of Birth:__________________ 

 

Day Phone:___________________________ Evening Phone:______________________________

 

 

________________________________________________________________________________________________________________________________________________________________________

Jersey Cares - 494 Broad St., Suite 103 - Newark, NJ 07102 - Phone: 973.424.1091 - Fax: 973. 424.1254 - www.jerseycares.org

 

 






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