As a parent or legal guardian of the registering child, I agree to the following:
Desire: My child desires to participate in the Push The Rock program
Possibility of Injury: The person listed may incur personal injury or bodily damage while participating in the activities of Push The Rock.
Necessity of Permission Slip: The person listed cannot participate in the Push The Rock program without releasing and holding harmless Push The Rock by completing the specific document or documents related to the specific program.
General Release and Discharge: I request that Push The Rock allow my child to participate in the program and in consideration thereof, agree to hereby release and discharge Push The Rock or any parties paid by Push The Rock or those volunteering on behalf of Push The Rock, from all actions, claims, costs, expenses, or damages of any kind growing out of or related to the program.
Release for Injury and Damages: I acknowledge that this form is a full and complete release for all injuries and damages which the above person may sustain as a result of participating in the Push The Rock program.
Treatment for Injury: I authorize the treatment of my child by a qualified and licensed medical doctor in the event of a medical emergency while said minor is participating in the Push The Rock program, including transportation to and from site. This authority is granted only after a reasonable attempt has been made to contact me, the parent / guardian of said minor.
Release of Pictures: I authorize Push The Rock to hereby use any pictures or video that may include the participant for promotional use.
Remains in Effect: You accepted this policy when you signed up for one of our programs.
Amendments: We may amend this policy at any time by posting a revised version on our website. The revised version will be effective at the time we post it.
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