Down Syndrome Association of Central New Jersey

General Liability Clause

Safety of our students and members is of the utmost importance. Yet, we, the staff of the DSACNJ-Club DREAMS recognize our obligation to make our students and their parents aware of the risks and hazards associated with participation.   Please review the following and print name as signature of your acknowledgement.

I, (Parent/Legal Guardian) on behalf of (Student), acknowledge and am fully cognizant of the inherent dangers in connection with participating in Club DREAMS classes, programs, instruction, including climbing equipment and related activities (referred to herein as the “Activities”) and that even when performed in conjunction with training, supervision and proper technique, the Activities require physical exertion and physical contact. During open play, I acknowledge that parental supervision is required at all times.  During programs and workshops, Club DREAMS staff will be present.  I realize that there is a risk of physical injury that may be incurred while engaging in any of the Activities, including, but not limited to, injuries that may be permanent or life threatening.

In consideration of my or the Student’s use of the facility to engage in the Activities, I hereby waive any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated or unanticipated, against Club DREAMS and the Down Syndrome Association of Central New Jersey and any of its members, directors, officers, affiliates, trainers, instructors, employees, volunteers, and students (whom are authorized by  Club DREAMS and the Down Syndrome Association of Central New Jersey   to perform on its behalf), and/or any other authorized agent, for any and all physical injury or death that might occur in connection with the Activities and I expressly assume the risk of all dangers or injury, including permanent, which are considered reasonably inherent to the participation in the Activities, regardless of whether such injuries result, in whole or in part, from the negligence of the above-referenced individuals and/or entities..

Representation of Insurance Coverage

I certify that I have adequate Health Insurance to cover any injury that (Student) may sustain as a result of the Activities, whether it be from negligence on the part of the business, gross negligence and/or omissions to any dangerous activity not mentioned in this waiver.  I agree to cover any and all costs and expenses incurred in training and/or within its facility by the enforcement of this waiver.  I understand that all attorney and court costs will be paid by me in the event I attempt to make a claim.

Club DREAMS offers a basic skills gymnastics class, dance, and sports for fitness, flexibility, balance, endurance, and coordination benefits and growth.  Safety of our students is of the utmost importance and supervision will be in place.  Yet, we, the staff of the DSACNJ-Club DREAMS recognize our obligation to make our students and their parents aware of the risks and hazards associated with the sport of gymnastics and dance. In sports, or activities involving any height or motion, students may suffer injuries, possibly serious, or catastrophic in nature, including permanent paralysis or death. I fully understand that the DSACNJ- Club DREAMS and its staff members are not physicians or medical practitioners or any kind. With the above in mind, I hereby release the DSACNJ-Club DREAMS staff to render temporary first aid to my child/children in the event of any injury or illness, and if deemed necessary by our staff to seek medical help, including the calling of an ambulance for transport to a hospital for said child, should the our staff deem this to be necessary. With the above in mind, and being fully aware of the risks and possibility of injury involved, I consent to have my child/children participate in the programs offered by the DSACNJ-Club DREAMS.  I, my executors or other representatives waive and release all rights and claims for damages that I or my child may have against the DSACNJ-Club DREAMS and or its representatives whether paid or volunteer. I have read and understand this ASSUMPTION OF RISK and WAIVER OF LIABILITY and MEDICAL AUTHORIZATION and I VOLUNTARILY affix my name in agreement.

Medical Emergency

The undersigned gives permission to DSACNJ – Club DREAMS, its board, staff, and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health for exercise.

With the above in mind, and being fully aware of the risks and possibility of injury involved, I consent to have my child/children participate in the programs offered by the DSACNj-Club DREAMS.  I, my executors or other representatives waive and release all rights and claims for damages that I or my child may have against the DSACNJ-Club DREAMS and or its representatives whether paid or volunteer. I have read and understand this ASSUMPTION OF RISK and WAIVER OF LIABILITY and MEDICAL AUTHORIZATION and I VOLUNTARILY affix my name in agreement.

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