Kayak Operator-Long Beach PRM Minor Participant Release - Parental Consent - 05-2-2022.pdf

OPERATOR1 / CITY OF LONG BEACH

DEPARTMENT OF PARKS, RECREATION, AND MARIINE

PARENTAL CONSENT

Release and Waiver of All Liability and Assumption of Risk Agreement

FOR GOOD AND VALUABLE CONSIDERATION, including permission for _______________________________________

(“MINOR”) to rent and use specified non-motorized, self-propelled aquatic equipment such as a kayak or paddleboard (“RENTAL”), the parent/guardian of the MINOR for myself and on behalf of the minor:

1. Consent to the MINOR’s volunteering for or participating in the RENTAL;

2. Am aware there are risks of exposure to directly or indirectly arising out of, contributed to, by, or resulting from an outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof, as a result of the MINOR’s participating in the RENTAL;

3. Am aware that the MINOR’s participating in the RENTAL includes a risk of possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19; and that while particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist;

4. Willingly agree, on behalf of the MINOR, to comply with the stated, reasonable, and/or customary terms and conditions related to the MINOR’s renting and participating in using the RENTAL as regards protection against drowning including but not limited to the ability to swim AND the use of safety vests or gear; and if I observe any unusual or significant hazard before or during the MINOR’s presence or participation, I will prevent from participating or remove the MINOR, as appropriate, from participation and bring such hazard to the attention of the nearest official immediately;

5. Agree that, prior to the MINOR’s participation in the RENTAL, the MINOR and I will inspect the facilities, equipment, and areas to be used, and, if either of us believes that any of them are unsafe, I will immediately advise the person supervising the RENTAL;

6. Acknowledge that the MINOR and I fully understand that the MINOR’s participation may involve risk of serious injury, illness, or death, including economic losses, which may result not only from the MINOR’s own actions, inaction's, or negligence, but also from the actions, in-actions, or negligence of others, the condition of the facilities, equipment, the use of personal safety equipment, including, but not limited to, a safety vest, or areas where the RENTAL is being conducted, the rules of play, or this type of RENTAL;

7. Knowingly and freely assume any and all risk of personal injuries or disease to the MINOR, permanent of partial disability, disease, or death and damages to the MINOR’s or my property, caused by or arising from the MINOR’s participation in the RENTAL and authorize Pedal Movement or the City of Long Beach to contact or employ a licensed physician to render any medical treatment that may be deemed necessary for the MINOR or to take and admit the MINOR to any hospital. If such medical treatment is required, I agree to pay all medical and hospital bills relating thereto;

8. Covenant not to sue or present any claim for personal injury, property damage, or wrongful death against Operator, the City of Long Beach, or their departments, officers, employees, members, heirs, successors, administrators, assigns, volunteers, or agents for damages attributable to the MINOR’s participation in the RENTAL;

9. Release, waive, discharge, and relinquish Operator, the City of Long Beach, or their departments, officers, employees, members, heirs, successors, administrators, assigns, volunteers, or agents (“RELEASEES”) from any liability, loss, damage, claim, demand, or cause of action against them arising from or attributable to the MINOR’s participation in

RENTAL, whether same shall arise by their negligence or otherwise;

10. Agree that photographs, pictures, slides, movies, or videos of the MINOR may be taken in connection with the MINOR’s participation in the RENTAL without compensation from the City of Long Beach or Operator and consent to the use of these photographs, pictures, slides, movies, or videos for any legal purpose;

11. Warrant that the MINOR is in good health and have no physical condition that would prevent the MINOR from participation in the RENTAL; and

12. Acknowledge and agree that Operator, the City of Long Beach, or their departments, officers, employees, members, heirs, successors, administrators, assigns, volunteers, or agents shall not be responsible for administering, providing, or assisting in administering medication to the MINOR.

THIS DOCUMENT RELIEVES THE CITY AND OTHERS FROM LIABILITY FOR PERSONAL INJURY, DISEASE, WRONGFUL DEATH, AND PROPERTY DAMAGE CAUSED BY NEGLIGENCE.

BOTH PARENTS MUST SIGN UNLESS ONLY ONE PARENT IS LIVING OR UNLESS ONLY ONE HAS LEGAL CUSTODY.

LEGALLY APPOINTED GUARDIANS MUST SIGN AND FURNISH A CERTIFIED COPY OF LETTERS OF GUARDIANSHIP.

I hereby certify on behalf of myself and the named minor that I have full knowledge of the nature and extent of the risks inherent in the EVENT and that I, on behalf of myself and the named minor, am voluntarily assuming said risks. I understand that I and the named minor will be solely responsible for any loss or damage, including personal injury, property damage, or death, the named minor sustains while participating in the RENTAL and that by signing this agreement I, on behalf of myself and the named minor, HEREBY RELEASE RELEASEES of all liability for such loss, damage, or death. I further certify that the named minor is in good health and has no conditions or impairments which would preclude his/her safe participation in the RENTAL. I further certify that my present age is 18 years of age or older. I am therefore of lawful age (18 years or older) and otherwise legally competent to sign this agreement, and that I have the legal capacity to act as the parent/guardian of the named minor above. I further understand that the terms of this agreement are legally binding and certify that I am signing this agreement, after carefully reading and understanding its provisions, of my own free will and without any form of coercion or duress.

I HAVE READ THIS DOCUMENT, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS AND ASSUME ALL RISKS

BY SIGNING IT, AND SIGN VOLUNTARILY.

PRINT PARENT/GUARDIAN NAME DATE OF BIRTH SIGNATURE DATE

PRINT PARENT/GUARDIAN NAME DATE OF BIRTH SIGNATURE DATE

I HAVE READ THIS DOCUMENT SIGNED BY MY PARENT(S) OR GUARDIAN(S) AND JOIN THE WAIVER, RELEASE AND ASSUMPTION OF RISK. I AM AWARE OF THE RISKS INVOLVED IN MY PARTICIPATION IN THE EVENT.

PRINT MINOR’S NAME SIGNATURE DATE

1 Commercial operator to provide rentals of non-motorized, self-propelled aquatic equipment such as kayaks and paddleboards