In consideration of the acceptance of the application as a participant in any recreation programs and/or activities of the City of Carpinteria, I hereby agree to assume all risks attendant upon myself while participating in any City of Carpinteria recreation programs and/or activities. I acknowledge the following: that participation in this program or activity is voluntary and involves physical activity. I agree as to myself and for my heirs, personal representatives or assigns, to hereby assume the risk of any injury from any cause whatsoever, including the negligence of the City; and to give up, waive, and discharge and release the City of Carpinteria, the Corporate Sponsors of this program, their respective officers, volunteers, agents, and employees, from any and all claims for loss or damage, for personal injury, bodily injury including death, or property damage and I agree to hold the City and Corporate Sponsors harmless, and covenant not to sue the City or others listed herein, should property loss, injury, or death occur during or as a result of my participation in this program. If necessary, the City may provide medical care for myself at my expense. By signing below, I acknowledge that I have read this assumption of risk, waiver and release of liability agreement, fully understand its terms, and I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing this agreement freely and voluntarily, and intend by my signature for this to be a complete and unconditional release of all liability to the greatest extent of the law I hereby waive, release, and discharge any and all claims for damages for death, personal injury, or property damage which I may have, or which may hereafter accrue to me as a result of my participation in the City of Carpinteria program or activity. I agree to indemnify and hold the City of Carpinteria and Corporate Sponsors harmless from liability. Further, I understand tthe City of Carpinteria, the Corporate Sponsors of this program, their officers, volunteers, agents, and employees are not responsible for the personal property of the participants in any Senior Center recreation program or activity.

I understand that during the City of Carpinteria recreation program and/or activity, my photograph may be taken by the City of Carpinteria, producers, sponsors, organizer, and/or assigns. I agree that my photograph, including video photography, film photography, or other reproduction of my likeness may be used without charge by the, producers, sponsors, organizers and/or it’s assigns for such purposed as they deem appropriate.

I hereby give my consent to be treated by a physician or surgeon is case of sudden illness or injury while participation in the City of Carpinteria recreation program and or activity. It is understood that the City of Carpinteria provides no medical insurance for such treatment, and that the cost thereof will be at my expense. If a personal physician is listed below, every effort will be made to contact such physician. However, the location of the activity or the nature of the illness or injury may require the use of emergency medical personnel.