The Way Foundation
EarthTeach Forest Park
Agreement to Participate
Express Acceptance of
Responsibility
I, the undersigned, have read the above
explanation of risks and dangers and fully realize that
participation at EarthTeach Forest Park can be a dangerous
activity involving the risk of injury and death.
I am aware that my
participation in activities at EarthTeach Forest
Park--and/or the participation of my ward(s)--entails risk
for which EarthTeach and the Way Foundation cannot be held
responsible. I acknowledge the fact that The Way Foundation
does not provide or carry medical insurance for its staff
or participants in EarthTeach events and has in no way
represented that such coverage is in place or may be
provided.
In recognition of the inherent risks of the activity, which
I (and/or any minor children for which I am responsible)
will engage in, I confirm that I am (they are) physically
and mentally capable of participating in the activity and
using the equipment.
I agree to be responsible for my own physical and emotional
well being during the program I am attending and promise to
inform one of the leaders if at any time I experience any
physical sensation or emotional discomfort which I consider
to be out of the ordinary or that is otherwise alarming to
me.
I understand the dangers and potential risk presented by
outings at EarthTeach Forest Park and hereby declare that I
(we/they) participate willingly and voluntarily and that I
expressly assume full responsibility for personal injury,
accidents or illness (including death) as well as
responsibility for damage to or loss of my personal
property as a result of any accident that may occur
thereon.
Because of these dangers, I realize the advisability of
following the instructions of leaders at all times and
agree to respond positively and quickly to such guidance.
Moreover, I recognize my obligation to ask questions to
satisfy myself about possible hazards and about precautions
and recommended procedures.
_____________________________
_____________________________________
Signature of Participant Participant’s Printed Name
(or guardian on behalf of)
Date: _____________________________________________
_____________________________________________
Address and Phone
number