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« All Events
April 6 @ 3:30 PM
-
5:00 PM
Free
«
Babysitter Training
Girls Empowerment Group
»
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Adult Name
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Last
Number of Adults Attending
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Email
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Phone Number
Number of Children Attending
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I agree
I hereby release any and all rights or claims for damages against The Town of Chester, CT, and Tri-Town Youth Services, its participants, employees and all individuals assisting in the instructing and conducting of the activities as part of "Let's Talk About Screens" Event, which will be referred to as "Event" subsequently throughout this waiver. I waive my right to sue the Town of Chester and Tri-Town Youth Services and hold these entities harmless from all liability of any nature, for any and all injuries, loss of damages, direct or indirect, suffered by any individual child(ren) or adults in any way connected with this Event, including claims of the negligence, resulting in any physical injury, illness (including death) or economic loss I may suffer or which may result from my participation in this Event, travel to and from the Activity (including air travel), or any events incidental to this Event”.
I am voluntarily participating in this Event. I understand that there are risks associated with my participation in this Event, such as physical and/or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability, death or economic loss. These injuries or outcomes may arise from my own or other’s actions, inactions, or negligence, or the condition of the Event location (s) or facility (ies). Nonetheless, I assume all risks of my participation in this Event, whether known or unknown to me, including travel to and from the Event (including air travel) or any events incidental to this Event.”
I am the parent or legal guardian of the Child Participant in the Event. I have read this document, and I am signing it freely. I understand the legal consequences of signing this document, including (a) releasing the Town of Chester and Tri-Town Youth Services from all liability on my and the Participant’s behalf, (b) waiving my and the Participants’ right to sue the above named entities, (c) and assuming all risks of Participant’s participation in this Event, including travel to and from the Event (including air travel) or any other activities incidental to this Event.
I acknowledge that I have been informed of the nature of the activity and that I am aware of the hazards and risks which may be associated with my participation in the above-named activity, including the risks of bodily injury, death, or damage to property which may occur from known or unknown causes.
Signing up and registering for this event through Tri-Town Youth Services' website confirms that I acknowledge the risks, the permissions and releases as stated above.
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Details
Date:
April 6
Time:
3:30 PM - 5:00 PM
Cost:
Free
Organizers
Tri-Town Youth Services
CES Social Development Subcommittee
Venue
Chester Meeting House
4 Liberty ST
Chester
,
CT
06412
United States
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Register
Register
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Participant First Name*
Participant Last Name*
Participant DOB
Please list any allergies participant has*
Which School does Participant attend?
CES
DRES
EES
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VRHS
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Email
Parent/Guardian First Name*
Parent/Guardian Last Name*
Parent/Guardian Email*
Phone*
Name of individual picking up participant*
Emergency Contact Phone Number*
Emergency Contact Name*
I grant Tri-Town Youth Services permission to use my/my child’s image in photos or videos for promotional, educational, and outreach purposes, including print, digital, and social media. I understand no compensation will be provided, and I release Tri-Town Youth Services from any liability related to image use.*
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