In consideration of being allowed to participate in City of Winston-Salem (the “City”) Recreation and Parks Department’s programs, events, or activities, or to use City facilities or equipment, I, the undersigned Participant and/or Parent or Guardian if Participant is a minor, agree on behalf of myself, on behalf of any minors in my legal custody, and on behalf of my heirs, executors, assigns, and successors, to the following:

Assumption of Full Responsibility for Risk of Bodily Injury, Death, or Property Damage. Participant acknowledges and understands that Participant is voluntarily participating in Recreation and Parks Department programs, events, or activities, or use of City facilities or equipment, at Participant’s own risk. This includes, without limitation, all risk of injury, death, illness, damage, or loss or theft of property that might result directly or indirectly out of Participant’s participation in the Recreation and Parks Department’s programs, events, or activities, or use of City of Winston-Salem facilities or equipment.

Release, Waiver, and Covenant Not to Sue. Participant understands that by signing this Agreement that the City of Winston-Salem, its employees, officers, agents, and volunteers, shall not be liable, and Participant expressly waives any claim of liability, for any injury, death, illness, damage, or loss or theft of property, whether caused by any negligent act or omission of the City, in connection with the Recreation and Parks Department’s programs, events, or activities, or use of City facilities or equipment. This waiver is intended to be a complete release, to the fullest extent permitted by law, of the City from any responsibility for any claims for injuries or damages whatsoever, to person or property, sustained by Participant pertaining to, related to, or arising directly or indirectly out of Participant’s participation in the Recreation and Parks Department’s programs, events, or activities, or use of City facilities or equipment. This includes, without limitation, injuries (including death) which may occur: (i) as a result of negligence or carelessness on the part of the City, (ii) out of a dangerous or defective condition of property or equipment, or (iii) the City’s negligent instruction or supervision.

Indemnity and Hold Harmless. Participant hereby releases and forever discharges the City and its employees, officers, agents, and volunteers from any and all claims, demands, expenses, costs, and liabilities of any kind or nature directly or indirectly related to, arising from, related to, or caused by Participant’s participation in the Recreation and Parks Department’s programs, events, or activities, or use of City facilities or equipment, except those claims that result from the sole negligence of the City or a City employee acting within the scope of his or her employment. Participant shall indemnify, defend, and hold harmless the City and its officers, agents, employees, and volunteers from and against any and all claims, demands, expenses, costs, and liabilities of any kind or nature to the extent proximately caused by the intentional, negligent, or reckless acts or omissions of the Participant.

Broad Application of Waiver and Severability. Participant expressly agrees that this Agreement is intended to be as broad and inclusive as permitted by North Carolina law and that if any portion is held to be invalid or beyond what is legally permissible, the balance shall continue to be in full legal force and effect.

Term. Participant agrees that this Agreement is broad in scope as to time, and it remains in full force and effect until this Agreement is superseded by a subsequent agreement.

Medical Care. Participant authorizes the City to seek emergency medical care, as the City deems necessary, for any Participant, and agrees to be responsible for all costs incurred.

Photographs. Participant acknowledges that the City may take publicity photographs and/or recordings of any program, activity, or event, and Participant hereby authorizes the use of Participant’s image for this purpose.

Full Agreement. Participant acknowledges that in executing this Agreement, it has carefully reviewed and had the opportunity to review the terms of this Agreement with counsel of its choice and is fully aware of the extent of its rights and obligations under this Agreement, without any duress or undue influence being imposed on such party. The text of this Agreement is the product of negotiation and is not to be construed as having been prepared by one party against the other but shall be construed as if all parties hereto jointly prepared this Agreement. The language of this Agreement shall not be construed presumptively against any of the parties to this Agreement.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ this Agreement and fully understand that it is a release of liability that waives any right Participant may have to bring a legal action against the City for any claim against the City, including but not limited to negligence of the City, based on Participant’s participation in the Recreation and Parks Department’s programs, events, or activities, or use of City facilities or equipment. I further acknowledge that no oral representations, statements, or inducements have been made, and that Participant is voluntarily signing this Agreement. I agree that signatures on registration forms that are transmitted to the City by facsimile or electronic mail shall have the same force and effect as original signatures. IF THE PARTICIPANT IS A MINOR, I warrant that I am the parent or legal guardian of the minor, and I execute this Agreement on their behalf.

Salem Lake Adventure Camp

Adventure Camp

Ages 5-8

Ages 9-12

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