JIA Foundation 2023 FAMILY RINKAN-GAKKOU-family overnight camp
Waiver and Release
This Waiver and Release relates to the undersigned Participant’s participation in the 2023 JIA Foundation
Family Summer Camp, hosted by the JIA Foundation, a Washington non-profit corporation from August 19,
2023 through August 20, 2023 (“Rinkan Gakkou”). If Participant is under the age of eighteen (18), then thisWaiver and Release must be reviewed and signed by Participant’s parent or legal guardian (“Guardian”). For
and in consideration of Participant’s being allowed to participate in Rinkan Gakkou, Participant/Guardianagrees to all of the following:
1. I understand that Rinkan Gakkou may exclude Participant/Guardian in the event that I or my child(ren) failto abide by Rinkan Gakkou’s health and safety protocols, disrupt, impede or interfere with the operations ofRinkan Gakkou, or threaten the health, safety or welfare of other participants or Rinkan Gakkou staff, andthat no refund of any fees will be made in such circumstances.
2. Participation in any program which involves physical activity exposes the camper to certain risks anddangers. Accidents and injuries are always a possibility, and it is impossible to foresee and protect the camperfrom all conceivable dangers. Participant/Guardian hereby acknowledges the risks and dangers associatedwith Participant’s participation in Rinkan Gakkou, which include in part, injury and/or damages to persons orproperty, serious bodily injury and death. Participant/Guardian voluntarily and knowingly assumes andaccepts any of such risks and dangers of injury or death to Participant.
3. Participant/Guardian agrees to forever RELEASE, DISCHARGE, INDEMNIFY, PROMISE NOT TO SUEAND TO SAVE AND HOLD HARMLESS JIA FOUNDATION and its officers, directors, volunteers, insurers,contractors and agents from any loss, liability, damage, or costs whatsoever arising out of or related to anyloss, damage, or injury (including death) to Participant arising out of or in any way connected with
Participant’s participation in Rinkan Gakkou. I further agree that if any such claim is made, I will indemnify
and defend the foregoing parties with respect to any such claim, injury or damage.
4. This Waiver and Release is governed by the laws of the state of Washington, and is intended to be as broad
and inclusive as is permitted by such law, and that, in the event any portion thereof is held invalid, it is agreed
that the balance shall continue in full legal force and effect.
5. Participant/Guardian grants to JIA Foundation the right to use, without any cost, Participant’s name,likeness, and image, in print, video, or electronic media form, but only in promotional materials or any accountor record of Participant’s participation in activities sponsored or promoted by JIA Foundation.
PARTICIPANT/GUARDIAN HAS READ THIS DOCUMENT AND AGREES TO ALL OF ITS TERMS.
PARTICIPANT/GUARDIAN UNDERSTANDS IT IS A LEGALLY BINDING AGREEMENT AND WAIVESCERTAIN LEGAL RIGHTS OF PARTICIPANT, INCLUDING, BUT NOT LIMITED TO A RELEASE,WAIVER, PROMISE NOT TO SUE AND A HOLD HARMLESS FOR ALL CLAIMS. THIS AGREEMENTSHALL BE BINDING UPON PARTICIPANT/GUARDIAN AND PARTICIPANT’S ESTATE, SUCCESSORS
AND ASSIGNS.
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Emergency Contact NameCell Phone NumberEmail Address