RELEASE OF LIABILITY, HOLD HARMLESS, AND AGREEMENT NOT TO SUE
I (Participant’s Name - If Participant is a minor, include name of parent
or guardian here _____________________________), and parent or guardian if applicable, hereby expressly and irrevocably consent to
minor’s participation, and all uses of “I” or “me” herein are made on behalf of both the minor and the parent or guardian, fully understand
that my participation in the _______________________________________________ (“Activity”) exposes me to any and all risks, both
known and unknown, of personal injury, death, or property damage that result while participating in the Activity however caused, even
if caused in whole or in part by the action, inaction or negligence of the City of Norwalk (“City”), including the Contracted Instructor and
the City’s officers, agents, employees, contractors, and volunteers (collectively referred to as “Released Parties”). Such risks include, but
are not limited to, contraction of the COVID-19 virus and physical and/or emotional injuries and/or death caused by contraction of the
COVID-19 virus. The risks assumed also include those inherent in the Activity offered by the Released Parties. I understand that there are
risks inherent in such Activity and hereby acknowledge that I am voluntarily participating in this Activity and agree to assume any such
risks.
In consideration of being permitted to participate in this Activity, I hereby expressly release, discharge, and agree for myself, my heirs,
administrators, executors, and assigns not to sue any of the Released Parties for any and all claims, suits or demands for personal injury,
death, property damage or other loss against the Released Parties, and each of them, arising out of, or in connection with, my participation in the Activity from whatever cause. To the fullest extent permitted by law, this waiver is intended to be a complete release of the
Released Parties for any and all responsibility for personal injuries, property damage or death sustained by me or others from participation
in the Activity whether arising out of or resulting from, including but not limited to, participation in the Activity.
I further agree to defend, indemnify and hold harmless the Released Parties, and each of them, including attorney’s fees and costs, from
any and all claims, demands, actions, or suits arising out of, or in connection with, or relating in any way to my participation in the Activity.
In case of accident or other emergency, I hereby authorize personnel or volunteers of the City of Norwalk or agents of the City to secure
medical care deemed necessary as a result of accident or injury to me. In the event of illness or injury, I hereby consent to whatever x-ray
examination, anesthetic, medical, surgical, or dental diagnosis, or treatment and hospital care considered necessary in the best judgment
of the attending physician, surgeon, or dentist, and performed by or under the supervision of a member of the medical staff or the hospital furnishing medical or dental services.
I also permit the use of activity/event photography and/or video of my child or myself for media promotion.
I READ AND UNDERSTAND ENGLISH, HAVE CAREFULLY READ THIS RELEASE OF LIABILITY, HOLD HARMLESS, AND
AGREEMENT NOT TO SUE, AND FULLY UNDERSTAND ITS CONTENTS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, SIGN IT FREELY AND VOLUNTARILY, THAT PARTICIPATION IN THE ACTIVITY IS STRICTLY VOLUNTARY, AND AGREE TO BE BOUND BY IT.
If any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
