PARENT OR LEGAL GUARDIAN ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
LONG ISLAND GOLF CAMPS, MICHAEL REILLY, PENINSULA GOLF CLUB, COLONIAL SPRINGS GOLF CLUB, BABYLON VILLAGE, DONALD E. CONROY GOLF COURSE, WIND WATCH GOLF CLUB, CLUB CORP.
I CERTIFY THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE CHILD I AM REGISTERING FOR THE GOLF CAMP OPERATED BY LONG ISLAND GOLF CAMPS.
I HEREBY ASSUME ALL OF THE RISKS OF HAVING MY CHILD PARTICIPATE IN THE GOLF CAMP OPERATED BY LONG ISLAND GOLF CAMPS AND MICHAEL REILLY, HELD AT EITHER PENINSULA GOLF CLUB, DONALD E.
CONROY GOLF COURSE, COLONIAL SPRINGS GOLF CLUB, OR WIND WATCH GOLF CLUB, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that my child/children is/are physically fit, have sufficiently prepared or trained for participation in the golf camp, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my child/children from participating in the golf camp. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the golf camp owner, specifically Michael Reilly, golf course operators, and any and all organizers, volunteers, staff, and helpers of the GOLF CAMP in which my child/children participate, and that it will govern my actions and responsibilities at said golf camp as the legal parent or guardian of the child/children participating. In consideration of my application and by permitting my child/children to participate in a GOLF CAMP operated by Long Island Golf Camps and Michael Reilly, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, specifically but not limited to Long Island Golf Camps and all staff thereof, Michael Reilly, golf camp owner and operator, and all golf courses and golf course staff in which the GOLF CAMP is conducted, for my child/children’s death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to my child/children including my traveling to and from the GOLF CAMP, THE FOLLOWING ENTITIES OR PERSONS: Michael Reilly, Long Island Golf Camps of 370 West Broadway Apt. 2D Long Beach NY 11561 and/or their directors, officers, employees, volunteers, representatives, and agents, the activity or event holders, activity or event sponsors, activity or event volunteers; and Peninsula Golf Club, Colonial Springs Golf Club, Donald E. Conroy Golf Course, Wind Watch Golf Club, and Club Corp.
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of my child/children participating in this activity or event, whether caused by the negligence of release or otherwise. I acknowledge that the golf camp and all activities associated with it may involve a test of a child’s physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by golf carts, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other campers, golf clubs, golf balls, and any and all objects or actions. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
(C) I certify that the child/children who are registering to participate in the golf camp are of good physical and mental health and that the child/children do not have any physical or mental disabilities or limitations that would limit their ability to participate in the golf camp or that would require special attention, need, and/or assistance. I also certify that if my child/children does have any physical or mental disabilities or limitations that would limit their ability to participate in the golf camp or that would require special attention, need, and/or assistance, I Will notify Long Island Golf Camps and Michael Reilly, and I will provide additional staffing needs and/or support for the child/children if it is deemed by the camp operators that such additional staffing and/or support is necessary.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT CHECKING THIS BOX CONSTITUTES A SUBSTITUTION FOR SIGNATURE.