I hereby release, waive, discharge and agree to indemnify and hold harmless the Roosevelt Student Wellness Center (RSWC), the Roosevelt Community Partnership (RCP) and the Hubbard Exempted Village School District (HEVSD), it’s directors, officers, employees, volunteers, and agents from any loss, liability, damage or any cost including any claim or demands therefore on account of an injury / damage to my property while I am on RSWC / HEVSD premises, or observing or using any facilities or equipment of the RSWC or participating in a RSWC program.

 

I fully understand the potential risk involved in participation with these programs.  In the event that a medical emergency should occur, I hereby give permission to receive medical treatment.

 

I hereby consent to have photographs / video images taken of me or my child by the RSWC staff member or professional approved by RSWC staff, and the use of such visual images at the discretion of the RSWC.  I hereby release the RSWC / HEVSD, its directors, officers, employees, volunteers, and agents from any and all liability which may arise from the taking or the use of such photographs / videos / images.  All negatives, positives, prints, or visual images shall remain the property of RSWC.

 

I hereby have read and voluntarily sign this release and waiver of liability.  I further agree to follow the RSWC Safety Policies and Procedures along with the Program Rules and Regulations and Membership Comfort and Safety Rules and Regulations.  Failure to do so may result in my removal from RSWC and its programs.  I have read and understand the RSWC Refund Policy on program / memberships.

 

Emergency Medical Release

 

I hereby give my consent permitting RSWC personnel to apply First Aid treatment until the family emergency medical personnel can be contacted.  I hereby give my consent to the RSWC personnel to call an ambulance service and transfer me to the closest emergency medical facility.  I assume any expenses incurred for emergency medical treatment deemed necessary by the RSWC staff and representatives.