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Parental waiver for participants under 18
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JEFFBAUMANNANNUALCARDBOARDCANOERACE
PARENTALWAIVERANDCONSENTFORM
I,theundersigned,astheparentorlegalguardianof____________________(printname),aminorchild,age_____,doherebygivemyfullconsentandapprovalforhim/hertoparticipateasapaddlerintheJeffBaumannAnnualCardboardCanoeRaceonJuly17,2015.IunderstandthatprovidingmyconsentmeansthatmychildwillberacingawatercraftconstructedfromcardboardandpackingtapeintheGrangerMeadowsParkKoiPond.Iunderstandthattherearecertainrisksofinjuryinherenttothisactivity,andIamwillingtoassumetheserisksonbehalfofmychild.IherebycertifythatmychildisfullycapableofparticipatingasapaddlerintheJeffBaumannAnnualCardboardCanoeRaceandthatmychildishealthyandhasnophysicaldisabilitiesorinfirmitiesthatwouldrestrictfullparticipationinthisactivity.Inadditiontogivingmyfullconsentformychildsparticipation,Idoherebywaive,releaseandholdharmlessDeWittCharterTownship,GrangerandallsponsorsoftheMeadowsCelebration,aswellasallofficersandrepresentativesoftheseentities,foranyinjurythatmaybesufferedbymychildinthecourseofparticipationinthisevent,whethertheresultofnegligenceoranyothercause.Nameofparentorlegalguardian(printed) Signatureofparentorlegalguardian Date
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