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The undersigned being the parents or guardian of the child listed below a minor, consent and assent to said child's participation int he athletic ventures, games, and sports events sponsored by the Skowhegan Parks and Recreation Department and /or Skowhegan Sports Boosters, and by this consent and assent do hereby assume all responsibility for any and all injuries and /or damages related thereto the undersigned, jointly and severally, agree to indemnify, protect, and save harmless the Skowhegan Parks and Recreation Department, the Skowhegan Sports Boosters, their officers, directors, agents, servants, and employees from any and all judgements, costs, and expenses whatsoever arising on account of any action, claim, or demand by said minor, or by any person acting for or an behalf of said minor in respect of any claimed injuries or damages. Photographs/Videos: The Department of Parks and Recreation may take pictures and or videos of participants at our programs, activities or special events. Please be aware that the picture and or video may appear in future promotional materials, including our brochures and web site.
Please fill in the Child's First and Last Name
Child's First Name
Child's Last Name
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Age of Child
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Date of acceptance of form
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