Parental Consent and Release of Liability

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PARENTAL CONSENT: The undersigned does hereby give permission for my minor child or legal guardian (hereinafter the “Participant”), to attend and participate in the American Cancer Society Cancer Action Network’s event, and any other related activities during the week specified on the form I have completed. 

 

LIABILITY RELEASE: In consideration of the American Cancer Society Cancer Action Network’s allowing the Participant to participate in the Event, I, the undersigned, do hereby release, forever discharge and agree to hold harmless the american cancer Society Cancer Action Network, Inc., its officers, directors, employees, volunteers, and agents (collectively herein “ACS CAN”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the Event, including the travel and lodging associated with the Event. I, the parent or legal guardian of this Participant, hereby grant my permission for the Participant to participate fully in the Event. Furthermore, I, on behalf of my minor Participant, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in the Event. The undersigned further hereby agrees to hold harmless and indemnify ACS CAN for any liability sustained by ACS CAN as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto. 

 

MEDICAL ACKNOWLEDGMENT.  The undersigned gives full permission to ACS CAN to render preventive assistance or first aid or seek treatment or medical care that seems reasonably necessary, including hospitalization, for the Participant’s health and well-being.  The undersigned releases and forever discharges ACS CAN from any claim whatsoever which arises or may hereafter arise on account of any first aid, medical treatment, or emergency services rendered in connection with the Participant’s participation in the Event. 

 

PHOTOGRAPHY/VIDEO RELEASE: The undersigned agrees to all terms set forth in ACS CAN’s Photography and Videography Consent and Release form and gives permission to ACS CAN to use the Participant’s image/likeness as contemplated by the Photography and Videography Consent and Release.  

 

Complete this form online at this link. 
 

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