Fayette County Parks and Recreation Department
Registration Form

Release from liability, indemnification, and photographic release:

Please read before signing.

The undersigned participant or guardian acknowledges that participation is voluntary and agrees to waive and release any and all rights and claims for damages against the Fayette County Board of Commissioners and all employees and members of the same, for any claim arising out of any injury or damages to myself/child. By signing this release, I/the guardian consent to such participation and also verify that adequate medical insurance is in effect during this period. In the event of an emergency and I cannot be reached, I give permission for authorities of Fayette County Parks and Recreation Department to seek immediate medical attention for myself/my child. I hereby consent to the use and reproduction of any and all photographs and/or video clips taken of me/my child in any form whatsoever for use in the Fayette County Parks and Recreation Department newsletters, brochures, flyers, on the county and department websites, and in any other publications produced for the Fayette County Parks and Recreation Department. Consent is also granted for any use of my name /child's name in any part of those publications listed above. I have read this document and am fully aware of the content and limitations, legal and otherwise.

Type your full name in the box below certifying that you have read the above agreement and agree to the terms.

Yes, I agree to the terms of registration.

Does the participant need a modification due to a disability to enjoy this program?

If the participant has a medical condition that the staff and instructor should have knowledge of, please state the condition here:

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