Waiver and Release for Leapstart After School
Permission to participate:I hereby give my full and complete permission, to the child(ren) enlisted by me, to participate in all after school activities except as noted. I further declare that I have the full authority over the child(ren) to do so and the information provided by me about the child(ren) is complete and accurate to the best of my knowledge.
Waiver and Release of Liability:In consideration of being permitted to participate in after school activities, I for myself, my child(ren) named herein, my heirs, executors and assigns, waive, release, discharge and covenant not to sue Leapstart Inc. DBA Leapstart After school, its officers, employees and agents (collectively "Leapstart") from all claims and liabilities (whether on behalf of my child(ren) named herein or for my own benefit) for personal injury, accidents or illness, and property loss arising from, but not limited to, my participation or my child's/children’s participation in any Leapstart Inc. after school program, session, activity or camp (the "ACTIVITIES"). This release includes a release of known and unknown claims and a release for the negligence of Leapstart, whether or not active or passive. I further waive any and all claims and release Leapstart from liability for damage or loss incurred or as a result of the actions or omissions of any third party while participating in the ACTIVITIES. I waive any and all causes of action in connection with the above, whether based in contract, tort or otherwise, to the extent allowed by applicable law.
Assumption of Risks:I understand that my child(ren)'s participation in the ACTIVITIES carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I understand that my child(ren) may be exposed to dangers and hazards, including but not limited to: use of common classroom tools such as scissors, glue, etc.; active outdoor play with other children; use of playground equipment; use of specialized equipment for certain activities at Leapstart After school & other school break camps; as well as the negligence of others. I know, understand and appreciate these dangers, hazards and other risks that are inherent in the ACTIVITIES. I hereby assert that my child(ren)’s participation is voluntary and that I knowingly assume all such risks.
Photo Release:I hereby grant permission to LEAPSTART to capture photo and video of my child(ren) named herein at the ACTIVITIES. LEAPSTART may use captured photos and videos of my child(ren) in LEAPSTART promotional materials without compensation, and may make such material publicly available on the internet. I agree to release LEAPSTART from any claims or liability resulting from their use of photos or videos.
Health Care:I hereby give permission to Leapstart to act according to their best judgment in any situation requiring medical attention for my child(ren) named herein. This includes routine health care, administering and/or dispensing prescribed medications, and seeking emergency medical treatment including ordering x-rays or routine tests. I agree to the release of any records necessary for insurance purposes. I acknowledge that it is my responsibility to provide medical insurance coverage for my child(ren) named herein while participating in the ACTIVITIES. Any costs of medical treatment provided to my child(ren) named herein that are not covered by medical insurance will be my sole responsibility. I give permission to LEAPSTART to arrange necessary related transportation for my child(ren). In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp to secure and administer treatment, including hospitalization, for my child(ren) named herein.
Indemnification, Hold Harmless and Defense:I agree to indemnify, hold harmless and defend LEAPSTART against any and all claims to which the "Waiver and Release" section of this agreement applies, including claims on behalf of any participating minor if the authorization is signed below. I also promise to indemnify, hold harmless and defend LEAPSTART against any and all claims for my own negligence, and any other claim arising from my conduct during the ACTIVITIES or which is a breach of this agreement. In accordance with these promises, I will reimburse LEAPSTART for any damages, reasonable settlements and defense costs, including attorney's fees, that LEAPSTART may incur because of any such claims made against them.
Acknowledgment of Understanding:I have read this agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I am signing this agreement freely and voluntarily, and intend by my signature for this agreement to be a complete and unconditional release of all liability to the greatest extent allowed by law. If any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force. This agreement shall be governed by and construed in accordance with the laws of California. Any legal suit, action or proceeding arising out of or related to this agreement or the Activities shall be resolved solely in the federal or state courts located in Santa Clara County, California.
The parent of the minor(s) named herein (the "Minor(s)") hereby executes this Permission to Participate, Waiver and Release of Liability, Assumption of Risk and Indemnification Agreement on behalf of the Minor(s).
COPPA NoticeUnder the Children's Online Privacy Protection Act ("COPPA"), we must provide you with notice before collecting "personal information" from your child(ren). The Federal Trade Commission considers a photograph, video or audio file containing a child's image or voice to be a child's "personal information." For more information about COPPA, please visit www.coppa.org.
Registration of your child(ren) at Leapstart After school gives your child(ren) access to many exciting activities, including some that utilize computer software applications and web-based services that are not operated by LEAPSTART but by third parties. In order for the campers to use some online programs and services, certain other personally identifying information, including a user name and/or email address, must be provided to the web site operator. Through some of these applications, your child(ren) may create photo, video, or audio projects or software applications that may contain your child(ren)’s image(s) or voice(s). In order to enroll in these courses, you must create the account for your child(ren). Under federal law, these web sites must provide parental notification and obtain parental consent before collecting personal information from children under the age of 13. For more information on the Children's Online Privacy Protection Rule (“COPPA”) and its regulation, please visit: https://www.ftc.gov/tips-advice/business-center/guidance/complying-coppa-frequently-asked-questions.