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Waiver & Release

Waiver & Release

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Bais Menachem of North Miami Beach, Inc.
BMNMB Kids Club

Date: ________________________

Name of Child: _________________________________________________________
Date of Birth: _____________________
Gender:   Male / Female
Activity: __________________________________
Parents Name: _________________________________________________________
Address: ______________________________________________________________
Contact Number: _______________________________________________________

RELEASE / WAIVER
For, and in consideration of Bais Menachem of North Miami Beach, Inc. permitting my minor child to enter upon the activities of Bais Menachem of North Miami Beach, Inc., and being permitted to participate in any activity of any nature conducted thereon, I hereby waive, release and discharge any and all claims, demands, actions or causes of action I may have individually or on account of injury to my minor child, or on account of property damage or death resulting from personal injury suffered by my child, caused in whole or in part by the negligence of Bais Menachem of North Miami Beach, Inc., its employees, agents, servants, officers, directors, volunteers, members, or other participants in the activity in which my child participates. I further agree to assume full responsibility for any risk of personal injury, property damage or death due to any negligence of Bais Menachem of North Miami, Inc., its employees, agents, servants, officers, directors, volunteers, members, or other participants in the activity in which my minor child participates, while my minor child is engaged in such activities upon said premises and covenant not to sue Bais Menachem of North Miami Beach, Inc., its employees, agents, servants, officers, directors, volunteers or members, for or on account of personal injuries, property damage or death resulting from personal injury in consideration of the privilege of my minor child entering upon said premises and participate in such activities. I agree, further, that my minor child will conduct herself/himself at all times in accordance with the policies, rules and regulations of Bais Menachem of North Miami Beach, Inc., and acknowledge that the privilege of being upon said premises and/or participation in such activities may be revoked if said policies, rules or regulations are not honored at all times. It is my express and specific desire to allow my minor child to participate in and compete in the activity of ___________________ and I have voluntarily agreed to sign the within Release, Waiver of Liability and Covenant Not to Sue and have agreed not to hold others liable for any injuries my minor child might sustain. It is my clear and specific intent by executing the within Release, Waiver of Liability and Covenant Not to Sue to release Bais Menachem of North Miami Beach, Inc., its employees, agents, officers, directors, volunteers and members from any and all liability for personal injury caused by to any negligence of Bais Menachem of North Miami Beach, Inc., its employees, agents, servants, officers, directors, volunteers or members.

Date: ______________________________Name of Child: ______________________________________
Parents Signature: __________________________________________________________________

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