Waiver and Release Agreement

MY FRENCH CLASSES’ PARTICIPANT STATEMENT OF UNDERSTANDING, WAIVER FORM AND ACKNOWLEDGEMENT

STATEMENT OF UNDERSTANDING

The following information is important for the safety and protection of your child. Please read this information and sign below.

  • I understand that my child will not be released to any person(s) not listed on the enrollment form.
  • I understand that I am not to leave my child at My French Classes’ program site unless a My French Classes staff member or volunteer is there to receive and supervise my child.
  • I understand that it is my responsibility to sign in my child when he/she enters My French Classes’ classroom and sign my child out before he/she leaves My French Classes’ program site.
  • I understand that my child will not be allowed to leave the program with an unauthorized person. Any person authorized to pick up my child must be listed on this form. Authorization by telephone will not be accepted.
  • I understand that My French Classes’ staff and volunteers are not allowed to babysit or transport children at any time outside My French Classes’ program site.

ACKNOWLEDGEMENT

I expressly acknowledge that there are certain dangers, risks, illnesses and personal injuries inherent in participating in My French Classes’ programs, events, classes, and/or other activities, which may result from unavoidable accidents or injuries. I understand that My French Classes and its employees, agents, counselors, teachers, representatives, successors and assigns assume no responsibility for loss, damage, illness or injury to person or property that my minor child(ren) may sustain as a result of their physical condition or resulting from their participation in any activities, programs, events, classes at and/or sponsored by My French Classes. I expressly acknowledge, on behalf my minor child(ren), heirs and executors, that I voluntarily assume the sole risk for any and all dangers, illnesses and personal injuries that may result from my minor child(ren)s’ participation in any events /activities/programs/classes while at My French Classes and/or sponsored by My French Classes.

I also acknowledge that My French Classes may use photographs, videotapes, television programs, motion pictures, tape recordings, or other similar media for promotional purposes. I hereby consent to the use of my and/or my minor child(ren)’s name(s) and/or likeness(es) in such materials to be exhibited and used for advertising, trade purposes, solicitation of patronage, promotional purposes, or other similar purposes, even if my and/or my minor child(ren)’s’ name(s) and/or likeness(es) are an integral part of such photograph, videotape, television program, motion picture, tape recording, or other similar media.

RELEASE

In consideration of My French Classes allowing my minor child(ren) to attend and/or participate in any programs, events, classes, or other activities at My French Classes and/or sponsored by My French Classes, I hereby, for my minor child(ren), heirs, and executors, waive, release and forever discharge My French Classes and its employees, agents, counselors, teachers, representatives, successors and assigns, from and against any and all rights and claims for any loss, damage, illness or injuries to person or property sustained as a result of my minor child(ren) attendance and/or participation in any such programs, events, classes, and other activities, whether or not such loss, damage or injury results from the negligence of My French Classes and its employees, agents, or representatives or from some other cause. My agreement to release My French Classes does not include any loss, damage or injury that results from My French Classes’ gross negligence or willful, wanton, or reckless misconduct.

I further waive any and all rights to inspect or approve the photograph, videotape, television program, motion picture, tape recording or other use of my and/or my minor child(ren)’s name(s) and/or likeness(es), including any written article, script, caption or other writing that may accompany such use of my and/or my minor child(ren)’s name(s) and/or likeness(es).

I hereby, for my minor child(ren), heirs, and executors, waive, release and forever discharge My French Classes and its employees, agents, counselors, teachers, representatives, successors and assigns, from and against any and all liability, claims, losses, costs, expenses or damages for libel, slander, invasion of privacy, conversion, defamation, appropriation of likeness or any other claim based on the use of my minor child(ren)s’ name(s) and/or likeness(es) in any such materials.

INDEMNIFICATION

I hereby represent and warrant to My French Classes that I have the authority to execute this Participant Waiver Form on behalf of my minor child(ren) as parent, guardian and/or next friend, if applicable. In the event of any misrepresentation or breach of the foregoing warranty by me or my minor child(ren), heirs, and executors, or in the event that I, my minor child(ren) or any other person nevertheless asserts any claim against My French Classes arising out of my minor child(ren)’s participation in any program, event, class or other activity as set forth herein, I agree to indemnify, hold harmless and defend My French Classes from and against any and all liability, claims, losses, costs, expenses or damages resulting therefrom, including, but not limited to, claims of loss, damage, illness or injury to person or property whether or not such loss, damage, illness or injury results from the negligence of My French Classes or from some other cause.

Please list all student and parent last names. One form submission per family is sufficient.

Please sign using your legal name.