City of Waterbury
General Hold Harmless, Disclaimer and Release of Liability
Please read carefully
I understand and acknowledge that there are inherent risks involved in participating in sports and recreational activities or program, which can include the risk of serious physical injury or death. I hereby agree and assume fully responsible for all risks associated with the participation of all listed individuals inall sports and recreational activities or programs, even if due to the negligence of the City of Waterbury, their agents, servants, or employees.
I hereby assume fully responsibility for any and all injuries or damages resulting from my or my children’s participation in said activities and hereby release, hold harmless and indemnify the City of Waterbury, its employees, officials and agents, from any and all liability, loss, injuries, death or damage to personal property that, my child or I may experience in connection with activities sponsored by the City of Waterbury Public Works Department Bureau of Parks and Bureau of Recreation.
I hereby consent to emergency medical procedures deemed advisable for my child in the event I cannot be reached and my child has sustained an injury. I acknowledge that The City does not provide accident or hospitalization insurance for participants of its activity’s or programs. All participants are advised to have adequate personal medical insurance coverage. I acknowledge that I am fully responsible for obtaining medical insurance coverage for the all individuals participating in any activity or program. I also consent to the use of my or my child’s photo, video, artwork etc. by the City of Waterbury for flyers, presentations etc.
I HAVE READ THIS WAIVER, HOLD HARMLESS AGREEMENT AND RELEASE OF LIABILITY AND FULLY UNDERSTAND ITS TERMS. I FURTHER UNDERSTAND THAT BY SIGNING THIS AGREEMENT THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS. I HAVE NOT BEEN INDUCED TO SIGN THIS AGREEMENT BY ANY PROMISE OR REPRESENTATION, AND I SIGN IT VOLUNTARILY AND OF MY OWN FREE WILL.