Registration Selection

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Child Information

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Agreement

WAIVER AND RELEASE OF LIABILITY AUTHORIZATION AND CONSENT

In return for being allowed to participate at the Humane Society of Macomb, I release and agree not-to-sue the Humane Society of Macomb, its employees. sub-contractors, sponsors and affiliates from all present and future claims that may be made by me, my family, estate. heirs, or assigns for property damage, personal injury, or wrongful death arising as a result of my participation and caused by the ordinary negligence of the parties listed above, wherever, whenever, or however the same may occur. I understand and agree that those listed above are not responsible for any injury or property damage arising out of my participation, even if caused by their ordinary negligence. I understand that my participation involves certain risks, including, but not limited to. serious injury and death. I am voluntarily participating at the Humane Society of Macomb with knowledge of the danger involved and agree to accept all risks of participation and all related activities. I agree to let the shelter use my name, likeness. and demographic information free of charge in any manner for any purpose, including marketing summer camp. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the stale of Michigan and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in Macomb County, Michigan.

I hereby give and grant to the Humane Society of Macomb. its employees, nominees. agents, successors, and assigns. unlimited authorization, consent, and permission to publish, republish. reproduce, distribute and. in any other manner, to use, any and all information about participant (excluding medical information) and any and all reproductions of their likeness (photographic or otherwise) and of their voice, and with or without the use or disclosure of participant’s name. I understand and agree that the authorizations. consents and permissions contained herein are given voluntarily and with the full understanding that no compensation or other payment of any kind will be paid to participant or to any other person for any of the agreements contained herein or for the exercise or use by the Humane Society of Macomb of any of the authorizations, consents or permissions granted in this Waiver and Release of Liability Authorization and Consent.

I am the parent or legal guardian of the participant. I am of legal age and am freely signing this agreement on behalf of the participant. I have read this form and understand that by signing this form I am giving up legal rights and remedies on behalf of myself, the participant, and his/her family, estate. heirs, and/or assigns. As parent or legal guardian of the participant named in this application for myself and for and on behalf of said participant, I hereby consent and agree to the foregoing Waiver and Release of Liability Authorization and Consent, and for myself and for and on behalf of said participant, I hereby give and grant the Humane Society of Macomb the authorizations. consents and permissions stated in the foregoing Waiver and Release of Liability Authorization and Consent, upon the terms and conditions stated therein.

Payment