Jungé Pavilion Waiver and Release Form

Jungé Pavilion Waiver and Release Form

For questions, contact chandra.hoffman@brynathyn.edu

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Fields marked with an * are required

I understand that no supervision is provided by the Academy of the New Church (the “Academy”) and that my use of the Academy’s equipment and facilities will be completely and totally at my own risk.

I understand and agree that the Academy is not responsible for property that is lost, stolen or damaged while in or about the Academy.

I agree to assume the entire responsibility and liability for use of the Academy’s Facilities and hereby release and forever discharge, the Academy and its affiliates and such other persons specified by them, as well as their respective insurers, employees, officers, directors, trustees, volunteers, advisors, agents, representatives, associates and their respective successors and assigns (herein individually a “Released Party” and collectively the “Released Parties”) from and against the following: Any and all claims, actions, rights of action, causes of action, manners of actions, damages, liabilities, losses and expenses (including without limitation, attorneys’ fees, court costs, appellate proceeding costs and the payment of any judgments, punitive and/or compensatory) relating to any and all losses or damages (including, without limitation, illness, bodily and personal injury, including death) arising out of or related to my use of all or any portion of the Facilities or my presence on the Academy’s premises whether or not such losses or damages are attributable in whole or in part to the fault, failure, negligence or other improper conduct of any of the Released Parties. This release extends and applies to and covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, damages, loss and liability and consequences thereof, occurring at any time after the execution date hereof. In consideration of my access to and use of the Facilities, I voluntarily and expressly waive any right to sue any of the Released Parties, and release the Released Parties from all responsibility and liability for any injuries and/or damages, even if I contend that such injuries and/or damages result, in whole or in part, from the fault, failure, negligence or other improper conduct on the part of the Released Parties.

I, the undersigned parent or legal guardian of the individual named in this Waiver and Release hereby
acknowledge that I have read and understand the terms of the Waiver and Release and agree on behalf of
myself, my child named in this Waiver and Release, and all other members of our family, to be bound by
all of the terms and conditions set forth therein, including the full and unconditional release contained
therein, to the same extent as such terms and conditions apply to our child named as the student therein.