Waiver and Release Agreement

Agreement

MY FRENCH CLASSES’ PARTICIPANT STATEMENT OF UNDERSTANDING, WAIVER OF LIABILITY, ASSUMPTION OF RISK, ACKNOWLEDGEMENT AND INDEMNIFICATION AGREEMENT

STATEMENT OF UNDERSTANDING

The following information is important for the safety and protection of your child(ren). Please read this information and sign below.

  • I understand that my child(ren) will not be released to any person(s) not listed on this form.
  • I understand that I am not to leave my child(ren) at My French Classes’ program site unless a My French Classes staff member or volunteer is there to receive and supervise my child(ren).
  • I understand that it is my responsibility to sign in my child(ren) when they enter My French Classes’ classroom and sign my child(ren) out before they leave My French Classes’ program site.
  • I understand that my child(ren) will not be allowed to leave the program with an unauthorized person. Any person authorized to pick up my child(ren) must be listed on this form.
  • I understand that My French Classes’ staff and volunteers are not allowed to babysit or transport children at any time outside My French Classes’ program site.

ACKNOWLEDGEMENT

I expressly acknowledge that there are certain dangers, risks, illnesses and personal injuries inherent in participating in My French Classes’ programs, events, classes, and/or other activities, which may result from unavoidable accidents or injuries. I understand that My French Classes and its owners, directors, officers, employees, affiliates, volunteers, participants, contractors, representative, agents, successors and assigns assume no responsibility for loss, damage, illness or injury to person or property that my child(ren) may sustain as a result of their physical condition or resulting from their participation in any activities, programs, events, classes at and/or sponsored by My French Classes. I expressly acknowledge, on behalf my child(ren), heirs, personal representatives, assigns and executors, that I voluntarily and freely assume the sole risk for any and all dangers, illnesses and personal injuries that may result from my child(ren)s’ participation in any events /activities/programs/classes while at My French Classes and/or sponsored by My French Classes.

AGREEMENT TO PAY OWN MEDICAL EXPENSES

I acknowledge, accept, and assume the risk of any and all medical conditions, limitations, or disabilities (whether temporary or permanent) that my child(ren) possess, whether known or unknown, which might contribute to or exacerbate any injury my child(ren) might sustain as a result of participation in My French Classes' programs, activities, classes.

I acknowledge and agree that if medical assistance (of any form, including emergency care, hospitalization, out-patient care, and/or physical therapy) is required or performed as a result of any injury my child(ren) sustain while participating in My French Classes’ programs, activities, classes, or observing, or using My French Classes' facilities, premises, or equipment, such medical assistance shall be at my own expense.

I ACKNOWLEDGE THAT MY FRENCH CLASSES DO NOT CARRY ANY TYPE OF ACCIDENT OR HEALTH INSURANCE ON THE PARTICIPANTS IN ITS ACTIVITIES. I ALSO ACKNOWLEDGE THAT INJURIES CAN BE CATASTROPHIC FOR THOSE WITHOUT PROPER MEDICAL COVERAGE.

MEDIA AUTHORIZATION

I also acknowledge that My French Classes may use photographs, videotapes, television programs, motion pictures, tape recordings, or other similar media for promotional purposes. I hereby consent to the use of my and/or my child(ren)’s name(s) and/or likeness(es) in such materials to be exhibited and used for advertising, trade purposes, solicitation of patronage, promotional purposes, or other similar purposes, even if my and/or my child(ren)’s’ name(s) and/or likeness(es) are an integral part of such photograph, videotape, television program, motion picture, tape recording, or other similar media.

RELEASE

In consideration of My French Classes allowing my child(ren) to attend and/or participate in any programs, events, classes, or other activities at My French Classes and/or sponsored by My French Classes, I hereby, for my child(ren), heirs ,personal representatives, assigns, and executors, waive, release and forever discharge My French Classes and its owners, directors, officers, employees, affiliates, volunteers, participants, contractors, representative, agents, successors and assigns, from and against any and all rights and claims for any loss, damage, illness or injuries to person or property sustained as a result of my child(ren) attendance and/or participation in any such programs, events, classes, and other activities, whether or not such loss, damage or injury results from the negligence of My French Classes and its owners, directors, officers, employees, affiliates, volunteers, participants, contractors, representative, agents, successors and assigns or from some other cause.

I further waive any and all rights to inspect or approve the photograph, videotape, television program, motion picture, tape recording or other use of my and/or my child(ren)’s name(s) and/or likeness(es), including any written article, script, caption or other writing that may accompany such use of my and/or my child(ren)’s name(s) and/or likeness(es).

I hereby, for my child(ren), heirs, personal representatives, assigns, and executors, waive, release and forever discharge My French Classes and its employees, agents, counselors, teachers, representatives, successors and assigns, from and against any and all liability, claims, losses, costs, expenses or damages for libel, slander, invasion of privacy, conversion, defamation, appropriation of likeness or any other claim based on the use of my child(ren)s’ name(s) and/or likeness(es) in any such materials.

INDEMNIFICATION

I hereby represent and warrant to My French Classes that I have the authority to execute this Participant Form on behalf of my child(ren) as parent, guardian and/or next friend, if applicable. In the event of any misrepresentation or breach of the foregoing warranty by me or my child(ren), heirs,personal representatives, assigns or executors, or in the event that I, my child(ren) or any other person nevertheless asserts any claim against My French Classes arising out of my child(ren)’s participation in any program, event, class or other activity as set forth herein, I agree to indemnify, hold harmless and defend My French Classes from and against any and all liability, claims, losses, costs, expenses or damages resulting therefrom, including, but not limited to, claims of loss, damage, illness or injury to person or property whether or not such loss, damage, illness or injury results from the negligence of My French Classes or from some other cause.

TERM

I understand that this agreement extends forever into the future and will have full force and legal effect each and every time my child(ren) participate in My French Classes’ programs, activities, classes, or observe, or use My French Classes' facilities, premises, or equipment.

ARBITRATION OF DISPUTES - TIME LIMIT TO BRING CLAIM

I understand that by agreeing to arbitrate any dispute as set forth in this section, I am waiving my right, and the right(s) of my child(ren) to maintain a lawsuit against:
- My French Classes, and
- its owners, directors, officers, employees, affiliates, volunteers, participants, contractors and agents, as well as their successors, predecessors-in-interest, and insurers (collectively referred to as “My French Classes’ Releasees”),

for any and all claims covered by this Agreement. By agreeing to arbitrate, I understand that I will NOT have the right to have such claim determined by a jury, and my child(ren) will NOT have the right to have claim(s) determined by a jury.

Reciprocally, My French Classes and My French Classes’ Releasees waive their right to maintain a lawsuit against me and the child(ren) below for any and all claims covered by this Agreement, and they will not have the right to have their claim(s) determined by a jury.

ANY DISPUTE, CLAIM OR CONTROVERSY ARISING OUT OF OR RELATING TO MY CHILDREN'S PARTICIPATION, - INCLUDING THE DETERMINATION OF THE SCOPE OR APPLICABILITY OF THIS AGREEMENT TO ARBITRATE, SHALL BE BROUGHT WITHIN ONE YEAR OF ITS ACCRUAL (i.e., the date of the alleged injury) AND BE DETERMINED BY ARBITRATION IN WASHINGTON DC BEFORE ONE ARBITRATOR. THE ARBITRATION SHALL BE ADMINISTERED BY JAMS PURSUANT TO ITS RULE 16.1 EXPEDITED ARBITRATION RULES AND PROCEDURES. JUDGMENT ON THE AWARD MAY BE ENTERED IN ANY COURT HAVING JURISDICTION. THIS CLAUSE SHALL NOT PRECLUDE PARTIES FROM SEEKING PROVISIONAL REMEDIES IN AID OF ARBITRATION FROM A COURT OF APPROPRIATE JURISDICTION.

This Agreement shall be governed by, construed and interpreted in accordance with the laws of the State of Maryland, without regard to choice of law principles. Notwithstanding the provision with respect to the applicable substantive law, any arbitration conducted pursuant to the terms of this Agreement shall be governed by the Federal Arbitration Act (9 U.S.C., Sec. 1-16). I understand and acknowledge that the JAMS Arbitration Rules to which I agree are available online for my review at jamsadr.com, and include JAMS Comprehensive Arbitration Rules & Procedures; Rule 16.1 Expedited Procedures; and, Policy On Consumer Minimum Standards Of Procedural Fairness.

ACKNOWLEDGMENT OF UNDERSTANDING

I certify that I am at least eighteen (18) years of age, and that I have read, and I understand this Waiver of Liability, Assumption of Risk, and Indemnification Agreement as indicated by my signature below. I acknowledge that I am signing freely and voluntarily, and intend by my signature to provide a complete and unconditional release of all liability for myself and my child(ren), heirs,personal representatives, assigns and executors.

IN SUMMARY, BY MY SIGNATURE BELOW, I ACKNOWLEDGE THAT IF I OR ANY OF MY CHILDREN OR THE OTHER PARTICIPANTS WHOSE NAMES ARE LISTED BELOW ARE INJURED IN ANY WAY, THIS WAIVER PREVENTS AND PROHIBITS ANY RECOVERY OF MONEY FROM ANY'OF MY FRENCH CLASSES' RELATED ENTITIES OR MY FRENCH CLASSES’ RELEASEES.

If I do not agree to any of these terms, I understand I do not need to sign it, and I may forego the participation of my child(ren), in the classes, programs and activities of My French Classes as the alternative.

Please list all persons authorized to pickup your child(en).
Please list first and last name(s) of children that you enrolled in My French Classes programs, separated by commas.
Please enter the parent email address used at the time of registration.
Please sign in using your legal name.