Waiver

I, the undersigned (legal relationship) of (“my child”), a minor, do hereby consent to my child’s participation in the voluntary program of the Town of Andover’s Youth Services Division identified on this form in the line directly above the term “program name” (“the Program”).


On behalf of myself and my child, and our respective heirs, executors and administrators, I also agree to forever release the Town of Andover, and all of their employees, agents, officials, board members, volunteers and also any and all individuals and organizations assisting or participating in programs of the Youth Services Division (“the Releasees”) from any and all claims, rights of action and causes of action that may have risen in the past, or may arise in the future, directly or indirectly, from personal injuries to my child or property damage resulting from my child’s participation in the Town of Andover’s voluntary programs in the Youth Services Division, or from the negligence, including the gross negligence, of the Releasees, including but not limited to transportation/travel, lodging, and the acts of my child, of other participants, and of third party contractors/vendors providing services to the Program.
 
On behalf of myself and my child, I also promise to indemnify, defend and hold harmless the Releases against any and all legal claims and proceedings of any description including reasonable attorneys’ fees that may have been asserted in the past, or may be asserted in the future, arising directly or indirectly and/or arising from personal injuries to my child or property damage resulting from my child’s participation in the Programn, or from the negligence, including the gross negligence, of the Releasees, .of my child, of other participants, and of third party contractors/vendors providing services to the Program.
 
I further affirm that I have read this Consent and Release Form and that I understand the contents of this Form. I understand that my child’s participation in the Program is voluntary and that my child and I are free to choose not to participate in the Program. By signing this Form, I affirm that I have decided to allow my child to participate in the Program with full knowledge that the Releasees will not be liable to anyone for personal injuries and property damage which my child may suffer in the Program.
Signed (Click "I Agree" as a signature) Date
 
I understand that my child needs to have an updated Emergency Information Sheet on file with AYS and I agree and accept all AYS policies including the photo policy, refund policy, and program cancellation policy. By signing I acknowledge I have read and understand fully the specific program/trip literature/materials/description for the Program.
 
DROP IN POLICY 
Participation in all Cormier Youth Center programs are on a drop-in, voluntary basis. The Andover Youth Services is not responsible for the care or supervision of members once they have left the Cormier Youth Center or once the Cormier Youth Center is closed. Please arrange with your child as to when it is appropriate to leave the facility and with whom.