Liability Waiver for Participant
As a participant (or as a parent of a participant under
18 years of age) in Ridgeville Park District programs, I recognize and acknowledge that there are certain risks of physical
injury, and I agree to assume the full risk of any injuries, including death, damages or loss which I may sustain as a result
of participating in any and all activities connected with or associated with the program(s). I do hereby fully release and discharge the Ridgeville Park District, their officers, agents,
servants and employees from any and all claims from injuries, including death, damages, or loss, which I may have or which
may accrue to me on account of my participation in the program(s). I further agree to indemnify and hold harmless and defend the Ridgeville Park District, their officers,
agents, servants and employees from any and all claims resulting from injuries, including death, damages or loss, which I
may have or which may accrue to me on account of my participation in the program(s).
I further agree to indemnify and hold harmless and defend the Ridgeville Park District, their
officers, agents, servants and employees from any and all claims resulting from injuries, including death, damages and losses
sustained by me and arising out of, connected with, or in any way associated with the activities of the program(s).
I also hereby consent to the use of my photograph in Ridgeville Park District brochures, publications, slide presentations,
etc.
I HAVE FULLY READ AND UNDERSTAND THE FOREGOING.
Signature:___________________________________ Date: ____/____/____
Print, fill out form and return with check/money-order
payable to Ridgeville Park District, mail to: 908 Seward St., Evanston, IL 60202
(Complete the questionaire for a $2 discount)
