Registration Form – Galway

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Additional Information (not required but helpful information) IEP, Special needs, disabilities, physical limitations, aide required, anxiety, shy, etc.

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PLEASE READ THE FOLLOWING CAREFULLY.  BY SIGNING BELOW, YOU AGREE TO THE FOLLOWING WAIVER.

I hereby grant permission for my child to participate in the Kids at Heart Club program. I fully understand and acknowledge that there are inherent risks and dangers associated with my child’s participation in the program. I also recognize the difficulties and challenges involved in indoor and outdoor recreation programs, and that my child is sufficiently physically and psychologically fit to participate and has not been advised otherwise by a physician.

I agree to indemnify and hold harmless the County of Saratoga, the Town of Galway, its employees, and personnel from any and all claims, causes of action, liability for injuries or damages which may arise as a result of participating in this program, including but not limited to reasonable attorney’s fees and the costs and disbursement of any legal actions and extending to employees, personnel, volunteers, instructors, etc. in responding to any emergency and/or medical situation or event.

Furthermore, I understand that during the event photographs may be taken and published through social media pages or affiliated websites. Some photographs may capture your child’s participation, directly or indirectly. I grant permission to use photos taken which may involve my child for publication on said platforms.

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Other people authorized to pick up youth (Must be 16 years or older and required to show ID)