RELEASE OF LIABILITY -- READ CAREFULLY – THIS AFFECTS YOUR LEGAL RIGHTS
In exchange for participation in the activity of “Cool Coyote Camp” an after school outdoor adventure camp for kids organized by Kathy Banks, of 912 Oak Grove Ave, Burlingame Ca 94010.

I agree for myself and for members of my family, to the following:

1. I and my child/children agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Kathy Banks, or the employees, representatives or agents of Cool Coyote Camp.

2. I and my child/children recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and family members, and further release and discharge Kathy Banks and also any Nature Preserves, Mid Peninsula Open space, State or County parks, beaches and any private residence for any injury, loss or damage arising out of my family’s use of or presence upon these outdoor facilities, weather caused by the fault of myself, my family, Kathy Banks or other third parties.

3. I agree to indemnify and defend Kathy Banks and Cool Coyote Camp against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family’s use of or presence upon the facilities listed above.

AS THE PARENT OR AUTHORIZED REPRESENTATIVE, I HEREBY GIVE CONSENT TO KATHY BANKS TO PROVIDE ALL EMERGENCY MEDICAL OR DENTAL CARE PRESCRIBED BY A DULY LICENSED PHYSICIAN (M.D.) OSTEOPATH (D.O.) OR DENTIST (D.D.S.). THIS CARE MAY BE GIVEN UNDER WHATEVER CONDITIONS ARE NECESSARY TO PRESERVE THE LIFE, LIMB OR WELL BEING OF MY CHILD.

Media Release

I give permission for unlimited use of any and all photos taken of my child at camp. I agree not to seek compensation in any form. That photos may be used for any purpose including, but not limited to, advertising or promotional products, or social media.

I have read this document and understand it. I further understand that by agreeing to this release, I voluntarily surrender certain legal rights.

Please Note: For Acton Academy Summer Camps, a minimum of 5 kids must sign up, or week will be canceled and a full refund will be processed.