Release of Liability by a Participant, and/or Parent or Guardian

By submitting the form below, I agree to the following:

I am unaware of any health or physical problem or condition that would, or might, limit my ability to safely participate in this program or activity. I agree that I am participating in this Program or Activity at my own risk and that I understand and recognize that there are risks and possible dangers inherent in any program or activity of this nature. I further acknowledge and agree that neither the St. Lucie Audubon Society, nor any person acting for or on behalf of the St. Lucie Audubon Society, has made any warranty or representation, expressed or implied, regarding the safety of participating in this program or activity.

I expressly waive, release, and hold harmless the St. Lucie Audubon Society and its officers, directors, employees and agents, or any person acting on behalf of The St. Lucie Audubon Society, from any and all claims, demands, actions and causes of action whatsoever on account of any loss, damage or injury to person or property suffered or incurred by me in connection with this Program or Activity, or any aspect of it, including but not limited to, any transportation arranged by, paid for, or provided by the St. Lucie Audubon Society.

This release shall be binding upon me and my heirs, next of kin, executors, administrators and assigns. By signing below, I acknowledge and agree that I have read and understand this Release and Waiver form and that the statements made herein are all true.

(Fields with * are required)

Date of activity *
Date of activity
Name *
Name
Minor's name (if applicable)
Minor's name (if applicable)
Parent/Guardian's Name (if applicable)
Parent/Guardian's Name (if applicable)
Date submitted *
Date submitted

Or download the form, fill it out and hand to leader before starting field trip.