Reach 1600 Foundation

Waiver and Release of Liability

I, the undersigned adult, affirm that I am a parent or legal guardian of the minor named below (referred to in this document as my “child”), and I agree to the following on behalf of myself and my child:
1. Voluntary Participation: I agree to the participation of my child in the activities, events, and classes conducted by Reach 1600 Foundation (the “Program”). I am also fully aware that any participation in this program is voluntary.
2. Governing Law: I agree that this Waiver and Release of Liability (this “Release”) is intended to be as broad and inclusive as permitted by the laws of the State of California. In the event of any cause of action or dispute, the laws of the State of California will apply.Section 2
3. Release of Liability: I acknowledge and accept that there are certain risks, known and unknown, that could result from my child’s participation in the Program. I, personally and on behalf of my child, hereby release and discharge Reach 1600 from any and all negligence connected to my child’s attendance at, or participation in the program, including traveling to and from the Program. I hereby release and hold harmless Reach 1600, its affiliated programs, affiliated organizations, directors, employees, agents, students, representatives, and volunteers from any and all liability for any resulting damage and/or injury my minor child may incur, including, but not limited to, expenses, physical injuries, mental anguish, emotional distress of my child and/or properties that resulted from or is in connection to my child’s participation in the Program.
4. Emergency Authorization: In the event of an accident and injury to my child, I hereby authorize Reach 1600 to arrange for any necessary or proper acts, medical or non-medical, to ensure the health of my child, under my own expense. This includes, but is not limited to, providing health care at a hospital or other institution, employing physicians, dentists, nurse, psychiatrist, or any other qualified person whose services may be needed, and authorizing any health care, including medicine, examinations, the use of anesthesia, surgery, and other operations and procedures.
5. Third Parties: I hereby acknowledge that the actions of all affiliated programs, affiliated organizations, directors, employees, agents, students, representatives, and volunteers do not represent those of Reach 1600. I hereby agree not to sue or hold Reach 1600 responsible or liable whatsoever for any unauthorized acts conducted by affiliated programs, affiliated organizations, directors, employees, agents, students, representatives, and volunteers.
6. Scheduling and Location Changes: I hereby acknowledge that the dates, times, and locations of the Program may change. I agree that Reach 1600 need not directly inform me of any changes in dates, times, and locations, but may instead provide my child with notification materials, including, but not limited to, flyers and notes to be brought home. I will be responsible for communicating with my child about any changes in dates, times, and locations.
By electronically signing this Waiver and Release of Liability, I acknowledge that I have been given the opportunity to consult with my own attorney, and I understand and voluntarily agree to the above terms on behalf of myself and my child.
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. *
Emergency Contacts
Primary Phone *
Primary Phone
Alternative Phone *
Alternative Phone
Primary Phone *
Primary Phone
Alternative Phone *
Alternative Phone