CITY OF EVANSTON ADOPT-A-PARK PROGRAM WAIVER & RELEASE OF LIABILITY
My child, , (insert name of minor child under the age of 18) in consideration of the permission extended to me by the City of Evanston, is hereby authorized and has my permission to participate in the Adopt-a-Park Program, and for other valuable consideration, I, the parent/guardian of the above named minor, for myself and on behalf of my child, do hereby FULLY AND FOREVER RELEASE AND DISCHARGE AND AGREES NOT TO SUE THE CITY OF EVANSTON, THEIR ELECTED OFFICIALS, OFFICERS, AGENTS, EMPLOYEES, AND ATTORNEYS, FOR LIABILITY FROM ANY AND ALL LOSS OR DAMAGE, PERSONAL INJURY, OR DEATH ARISING OUT OF OR IN ANY WAY ASSOCIATED WITH MY PARTICIPATION IN THE ADOPT-A-PARK PROGRAM.
I UNDERSTAND THAT MY CHILD MAY PARTICIPATE IN PHYSICAL ACTIVITY AND THERE ARE INHERENT RISKS WITH VOLUNTEERING IN THE ADOPT-A-PARK PROGRAM. THERE EXISTS THE POSSIBILITY THAT MY CHILD MAY EXPERIENCE ONE OR MORE OF THE FOLLOWING INCLUDING: CRAMPS, SPRAINS, BRUISES, MUSCLE INJURIES, FRACTURES, CARDIOVASCULAR OR PULMONARY PROBLEMS, AND OTHER INJURIES INCLUDING DEATH.
I have read this document and understand that it is a promise not to sue and that I release the City of Evanston, elected officials, employees, agents and attorneys for any and all claims. I considered this Release and Waiver carefully before signing it. If I am signing this document with an electronic signature, I execute this Release and Waiver with the intent to sign the record.
Date: __________
Volunteer/Minor’s name (PRINT): ___________________________________
Parent/Guardian’s name (PRINT): ___________________________________
Parent/Guardian’s signature: _______________________________________