|TERMS & CONDITIONS|
|Participant Liability Waiver and Hold Harmless Agreement
|I desire to participate in one or more of the programs sponsored by the Highland Park Senior
Center, including, but not limited to, any excursion, event or activity organized by the Highland Park Senior Center and/or the Medical Equipment Loan Closet lending program (each a “Senior Center Program”).
I have read this form carefully and am aware that by signing this form and participating in any Senior Center Program, I am WAIVING and RELEASING all claims arising out of such participation. In consideration of the City of Highland Park (the “City”) accepting me as a participant in Senior Center Programs, I hereby agree as follows:
Acknowledgement of Voluntary Participation
I acknowledge and agree that: (1) my participation in each Senior Center Program is voluntary; (2) my participation in each Senior Center Program will not create any special duty relationship between me and the City; and (3) I will not be covered by, or eligible for compensation from, any of the City insurance or self-insurance policies or programs during, or as a result of, my participation in any Senior Center Program. I warrant and represent that, before participating in a Senior Center Program, I will bring to the attention of a City employee or City official who is present during such Senior Center Program all questions or concerns that I have regarding my participation in such Senior Center Program. I acknowledge and understand that the City reserves the right to deny or cease my participation in any and all Senior Center Programs at any time for any reason.
Risk of Injury
I recognize and acknowledge that participation in Senior Center Programs involves risks of bodily injury, death, and property loss. I hereby agree to, and do, assume the full risk of any injuries, including death, and of any property loss, and of all expenses, costs, damages, and losses that I may sustain as a result of my participation in any and all Senior Center Programs, or as a result of the condition, maintenance, and use of any public property involved in the Senior Center Programs.
Waiver and Release of Claims
I hereby agree to, and do, waive, release and relinquish all claims, demands, rights of action, damages, liabilities and controversies of every kind, known and unknown, present and future, that I may have against the City and its officers, agents, servants, employees, volunteers, independent contractors, insurers, related or affiliated individuals or entities, successors and assigns arising out of, connected with, or in any way related to the Senior Center Programs or my participation therein, or as a result of the condition, maintenance, and use of the public property involved in Senior Center Programs, or in any way related to the provision of emergency medical care in accordance with this waiver and agreement.
I hereby further agree to indemnify and hold harmless the City and its officers, agents, volunteers, independent contractors, servants, employees, insurers, related or affiliated individuals or entities, successors and assigns from any and all claims, lawsuits, demands, damages, liabilities, losses and expenses, including attorneys' fees and administrative expenses, of every kind, known and unknown, present and future, arising out of, connected with, or in any way related to my participation in the Senior Center Programs, or as a result of the condition, maintenance, and use of the public property involved in Senior Center Programs.
Emergency Medical Care Authorization
In the event of any emergency, I authorize the City to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed reasonable and necessary for my immediate care and agree that I will be responsible for payment of any and all medical services rendered. I further authorize the City to administer cardiopulmonary resuscitation or other emergency life-saving techniques as may be necessary for my immediate care.
Recordings and Reproductions
I hereby grant the City permission to use any photographs, motion pictures, videos, recordings, and other reproductions of me captured during my participation in any Senior Center Program. I agree that any such photographs, motion pictures, videos, recordings, and other reproductions will be the property of the City and may be used in any publication, website, or television programming of the City.
I understand and agree that the above stated conditions will remain in full force and effect for my participation in all Senior Center Programs unless and until I submit a revocation of the terms of this agreement in writing to the Manager of Senior Services for the City. I understand and agree that in the event I submit such a revocation, the City may refuse to allow me to participate in subsequent Senior Center Programs.
I have read and fully understand this PARTICIPANT LIABILITY WAIVER AND HOLD HARMLESS AGREEMENT and execute it of my own free will and without any reservation whatsoever.
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