On Saturday, August 3rd, from 11am-3pm, all YEP members and their families are invited to a picnic at the Lions Club Shelter at Wakanda Park in Menomonie Directions At This Link. (Just take a left after Wakanda water park and the tennis courts on Game Park Rd. and we’ll be by the lion drinking fountain)
YEP will provide pizza, as well as water or juice to all (students and family) who RSVP.
Below you’ll see the questions we always have to ask when having an event outside of school. Also, to help us with an estimate of how many will be attending, we would love if you could tell us how many people will be attending, including you. Please fill out the form below.
Agreement for Assumption of Risk, Indemnification, Release, and Consent for Emergency Treatment
I understand that I am being asked to read each of the following paragraphs carefully. I understand that if I wish to discuss any of the terms contained in this agreement, I may contact Arbor Place, Inc. Manager of Prevention Services, Sherry Berg at 715-235-4537 Extension 220 or [email protected]
Assumption of Risk: I understand that not all risks can be foreseen and there are some risks which are unpredictable. I understand that certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I am aware that all care will be taken by Arbor Place, Inc. staff to reduce the possibility of risk, but that participation in the Youth Empowerment Program activities and events may involve some inherent risks. I understand that no coverage for health and accident insurance is provided for my child by Arbor Place, Inc. I know, understand, and appreciate the risks that are inherent in the above listed programs and activities. I hereby assert that my child’s participation is voluntary and I knowingly assume all such risks.
Hold Harmless, Indemnity and Release: In consideration of my participation in these activities, I, for myself, spouse, heirs, personal representatives, estate or assigns, agree to defend, hold harmless, indemnify and release, Arbor Place, Inc. and their officers, employees, agents and volunteers who are involved, from and against any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, or personal injury, or death which may result from my participation in the above-listed program. This release includes claims based on the negligence of Arbor Place, Inc. and their officers, employees, agents and volunteers, but expressly does not include claims based on their intentional misconduct or gross negligence. I understand that by agreeing to this clause I am releasing claims and giving up substantial rights, including my right to sue.
Consent for Emergency Treatment: I authorize Arbor Place, Inc., and their designated staff to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
