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Waiver and Release of All Claims

  1. Please read carefully. By registering yourself or your minor child/ward to participate in programs sponsored by the City of Quincy, you waive and release the City for all claims for injuries arising from such participation.
    It is important to me that I or my child/ward (“Child”) participates in programs sponsored by the City of Quincy (“City”). I recognize and acknowledge there are certain risks of physical injury arising from the activities in such program(s). I represent to the City that I or my Child is physically capable of participating in a program in light of their health history, weight and general physical condition. I will advise the City of any change in my or my Child’s physical condition which might in any way adversely affect the ability to safely participate in any portion of a program sponsored by the City. Being fully informed as to these risks, and based on my knowledge of my or my Child’s physical condition and ability, and in consideration of the City allowing me and/or my Child to participate, and on behalf of my spouse and my Child, with regard to any injury, damage, harm or loss, regardless of severity, arising from my or my Child’s participation in such program notwithstanding the cause (a “Loss”): (1) I assume the full risk of any such Loss; (2) I waive and relinquish all claims for a Loss; (3) I release the City and its officers, agents, servants, employees, contractors and volunteers from any and all claims for a Loss; and (4) I will indemnify, defend and hold the City and its officers, agents, servants and employees harmless from and against any and all claims resulting from a Loss.
  2. Media Disclaimer
    By participating in programs and special events, I and on behalf of my Child expressly grant the City the royalty free license and complete release to take photos and videos of myself and my Child for publication or any other use as the City deems necessary.
  3. I have read and fully understand the program details and waiver and release of all claims.
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  5. This field is not part of the form submission.