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  1. I do hereby agree that by (participation) (allowing my child to participate) in the above named activity, sponsored by the Cocoa Beach Parks and Recreation Department, I will assume all risks and hazards incidental to the conduct of the program. In case of injury, I will release, absolve, indemnify and hold harmless the City of Cocoa Beach, its governmental agencies, the organizers, sponsors, supervisors, owners of any property or equipment used in the program, providers of any transportation connected with the program, any and all of them. I AM AWARE THAT THE CITY OF COCOA BEACH DOES NOT PROVIDE INSURANCE COVERAGE.
  2. 2.) I acknowledge and accept the risk that my child(ren) and other members of my family or household, and I may be exposed to or be infected by Covid-19 by my child(ren) attending the Camp program and that such exposure or infection may result in personal injury, illness, permanent disability, disfigurement and death. I acknowledge and accept the risk to have contact with individuals, who have been exposed to and/or have been diagnosed with one or more communicable diseases, including but not limited to COVID – 19 or other medical conditions, or diseases. I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and/or others, including, but not limited to, City employees, volunteers, and program participants and their families.
  3. 3.) I agree that my child(ren) will comply with the stated and customary terms and conditions for participation.
  4. Acknowledgement*
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  6. This field is not part of the form submission.