ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
The undersigned, being the parent or guardian of the above named child (the “Participant”) who is participating in the Pingpod Inc. table tennis children’s program (the “Program”), hereby agrees as follows:
In consideration of the Participant being allowed to participate in the Program, the undersigned for his/herself and on behalf of the Participant:
Hereby assumes all of the risks of participating in any activities associated with the Program, including by way of example and not limitation, any risks that may arise from (i) negligence or carelessness on the part of Pingpod Inc., its affiliates, officers, directors and employees (“Pingpod Parties”), (ii) dangerous or defective equipment or property owned, maintained, or controlled by any of the Pingpod Parties and (iii) from actions or conduct of other participants in the Program.
Certifies (i) that Participant is physically fit and has not been advised to not participate by a qualified medical professional and (ii) that there are no health-related reasons or problems which preclude Participant’s participation in the Program.
Waives, releases and discharges the Pingpod Parties and the Owner of the real property in which the Program takes place from any and all liability, claims or damages including but not limited to, liability arising from the negligence or fault of the Pingpod Parties, for Participant’s personal injury, disability or death, or any property damage, property theft, or damages of any other kind which may hereafter occur to the Participant arising out of or relating to participation in the Program.
Agrees to be responsible for any damages, claims, or liabilities arising out of the Participant’s conduct or actions during the Program.
Agrees that the Participant will follow all rules established by the Pingpod Parties for conduct during the Program and acknowledges that the Pingpod Parties may revoke the Participant’s right to participate in the Program for not following such rules, or for any other basis in the Pingpod Parties’ determination
Understands that while participating in this activity, Participant may be photographed or videotaped. Unless permission is revoked, such photo, video, or film likeness may be used for any legitimate business purpose by Pingpod. Inc.
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 I sign it of my own free will.
UNACCOMPANIED DISMISSAL PERMISSION for ages____ and above:
I certify that my child is above the age of ___.
I hereby give permission for my child,_____________________________________, to leave the Program at dismissal time without an adult accompanying him/her, throughout the 2023 Program.
I understand that once students have been dismissed from camp,they may not return to camp that day.________________________________________________________________
Signature of Parent or Guardian
By:______________
Print Name:
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OLDER VERSIONS BELOW
(8/8/2022)
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
The undersigned, being the parent or guardian of the below named child (the “Participant”) who is participating in the PingPod Inc. table tennis children’s program at 321 W 37th street, New York, New York (the “Program”), hereby agrees as follows:
In consideration of the Participant being allowed to participate in the Program, the undersigned for his/herself and on behalf of the Participant:
Hereby assumes all of the risks of participating in any activities associated with the Program, including by way of example and not limitation, any risks that may arise from (i) negligence or carelessness on the part of PingPod Inc., its affiliates, officers, directors and employees (“PingPod Parties”), (ii) dangerous or defective equipment or property owned, maintained, or controlled by any of the Pingpod Parties and (iii) from actions or conduct of other participants in the Program.
Certifies (i) that Participant is physically fit and has not been advised to not participate by a qualified medical professional and (ii) that there are no health-related reasons or problems which preclude Participant’s participation in the Program.
Waives, releases and discharges the PingPod Parties and the Owner of the real property in which the Program takes place from any and all liability, claims or damages including but not limited to, liability arising from the negligence or fault of the PingPod Parties, for Participant’s personal injury, disability or death, or any property damage, property theft, or damages of any other kind which may hereafter occur to the Participant arising out of or relating to participation in the Program.
Agrees to be responsible for any damages, claims, or liabilities arising out of the Participant’s conduct or actions during the Program.
Agrees that the Participant will follow all rules established by the PingPod Parties for conduct during the Program and acknowledges that the PingPod Parties may revoke the Participant’s right to participate in the Program for not following such rules, or for any other basis in the PingPod Parties’ determination
Understands that while participating in this activity, Participant may be photographed or videotaped. Unless permission is revoked, such photo, video, or film likeness may be used for any legitimate business purpose by PingPod. Inc.
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 I sign it of my own free will.
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
The undersigned, being the parent or guardian of the below named child (the “Participant”) who is participating in the PingPod Inc. table tennis children’s program at 97 Broadway, Brooklyn, New York (the “Program”), hereby agrees as follows:
In consideration of the Participant being allowed to participate in the Program, the undersigned for his/herself and on behalf of the Participant:
Hereby assumes all of the risks of participating in any activities associated with the Program, including by way of example and not limitation, any risks that may arise from (i) negligence or carelessness on the part of PingPod Inc., its affiliates, officers, directors and employees (“PingPod Parties”), (ii) dangerous or defective equipment or property owned, maintained, or controlled by any of the PingPod Parties and (iii) from actions or conduct of other participants in the Program.
Certifies (i) that Participant is physically fit and has not been advised to not participate by a qualified medical professional and (ii) that there are no health-related reasons or problems which preclude Participant’s participation in the Program.
Waives, releases and discharges the PingPod Parties and the Owner of the real property in which the Program takes place from any and all liability, claims or damages including but not limited to, liability arising from the negligence or fault of the PingPod Parties, for Participant’s personal injury, disability or death, or any property damage, property theft, or damages of any other kind which may hereafter occur to the Participant arising out of or relating to participation in the Program.
Agrees to be responsible for any damages, claims, or liabilities arising out of the Participant’s conduct or actions during the Program.
Agrees that the Participant will follow all rules established by the PingPod Parties for conduct during the Program and acknowledges that the PingPod Parties may revoke the Participant’s right to participate in the Program for not following such rules, or for any other basis in the PingPod Parties’ determination
Understands that while participating in this activity, Participant may be photographed or videotaped. Unless permission is revoked, such photo, video, or film likeness may be used for any legitimate business purpose by PingPod. Inc.
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 I sign it of my own free will.
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
The undersigned, being the parent or guardian of the below named child (the “Participant”) who is participating in the PingPod Inc. table tennis children’s program at 515 E 86th street, New York, New York (the “Program”), hereby agrees as follows:
In consideration of the Participant being allowed to participate in the Program, the undersigned for his/herself and on behalf of the Participant:
Hereby assumes all of the risks of participating in any activities associated with the Program, including by way of example and not limitation, any risks that may arise from (i) negligence or carelessness on the part of PingPod Inc., its affiliates, officers, directors and employees (“PingPod Parties”), (ii) dangerous or defective equipment or property owned, maintained, or controlled by any of the PingPod Parties and (iii) from actions or conduct of other participants in the Program.
Certifies (i) that Participant is physically fit and has not been advised to not participate by a qualified medical professional and (ii) that there are no health-related reasons or problems which preclude Participant’s participation in the Program.
Waives, releases and discharges the PingPod Parties and the Owner of the real property in which the Program takes place from any and all liability, claims or damages including but not limited to, liability arising from the negligence or fault of the PingPod Parties, for Participant’s personal injury, disability or death, or any property damage, property theft, or damages of any other kind which may hereafter occur to the Participant arising out of or relating to participation in the Program.
Agrees to be responsible for any damages, claims, or liabilities arising out of the Participant’s conduct or actions during the Program.
Agrees that the Participant will follow all rules established by the PingPod Parties for conduct during the Program and acknowledges that the PingPod Parties may revoke the Participant’s right to participate in the Program for not following such rules, or for any other basis in the PingPod Parties’ determination
Understands that while participating in this activity, Participant may be photographed or videotaped. Unless permission is revoked, such photo, video, or film likeness may be used for any legitimate business purpose by PingPod. Inc.
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 I sign it of my own free will.
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
The undersigned, being the parent or guardian of the below named child (the “Participant”) who is participating in the PingPod Inc. table tennis children’s program at 42 Allen Street, New York, New York (the “Program”), hereby agrees as follows:
In consideration of the Participant being allowed to participate in the Program, the undersigned for his/herself and on behalf of the Participant:
Hereby assumes all of the risks of participating in any activities associated with the Program, including by way of example and not limitation, any risks that may arise from (i) negligence or carelessness on the part of PingPod Inc., its affiliates, officers, directors and employees (“PingPod Parties”), (ii) dangerous or defective equipment or property owned, maintained, or controlled by any of the PingPod Parties and (iii) from actions or conduct of other participants in the Program.
Certifies (i) that Participant is physically fit and has not been advised to not participate by a qualified medical professional and (ii) that there are no health-related reasons or problems which preclude Participant’s participation in the Program.
Waives, releases and discharges the PingPod Parties and the Owner of the real property in which the Program takes place from any and all liability, claims or damages including but not limited to, liability arising from the negligence or fault of the PingPod Parties, for Participant’s personal injury, disability or death, or any property damage, property theft, or damages of any other kind which may hereafter occur to the Participant arising out of or relating to participation in the Program.
Agrees to be responsible for any damages, claims, or liabilities arising out of the Participant’s conduct or actions during the Program.
Agrees that the Participant will follow all rules established by the PingPod Parties for conduct during the Program and acknowledges that the PingPod Parties may revoke the Participant’s right to participate in the Program for not following such rules, or for any other basis in the PingPod Parties’ determination
Understands that while participating in this activity, Participant may be photographed or videotaped. Unless permission is revoked, such photo, video, or film likeness may be used for any legitimate business purpose by PingPod. Inc.
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 I sign it of my own free will.
ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
The undersigned, being the parent or guardian of the below named child (the “Participant”) who is participating in the PingPod Inc. table tennis children’s program at 13-18 Steinway street, Astoria, Queens (the “Program”), hereby agrees as follows:
In consideration of the Participant being allowed to participate in the Program, the undersigned for his/herself and on behalf of the Participant:
Hereby assumes all of the risks of participating in any activities associated with the Program, including by way of example and not limitation, any risks that may arise from (i) negligence or carelessness on the part of PingPod Inc., its affiliates, officers, directors and employees (“PingPod Parties”), (ii) dangerous or defective equipment or property owned, maintained, or controlled by any of the PingPod Parties and (iii) from actions or conduct of other participants in the Program.
Certifies (i) that Participant is physically fit and has not been advised to not participate by a qualified medical professional and (ii) that there are no health-related reasons or problems which preclude Participant’s participation in the Program.
Waives, releases and discharges the PingPod Parties and the Owner of the real property in which the Program takes place from any and all liability, claims or damages including but not limited to, liability arising from the negligence or fault of the PingPod Parties, for Participant’s personal injury, disability or death, or any property damage, property theft, or damages of any other kind which may hereafter occur to the Participant arising out of or relating to participation in the Program.
Agrees to be responsible for any damages, claims, or liabilities arising out of the Participant’s conduct or actions during the Program.
Agrees that the Participant will follow all rules established by the PingPod Parties for conduct during the Program and acknowledges that the PingPod Parties may revoke the Participant’s right to participate in the Program for not following such rules, or for any other basis in the PingPod Parties’ determination
Understands that while participating in this activity, Participant may be photographed or videotaped. Unless permission is revoked, such photo, video, or film likeness may be used for any legitimate business purpose by PingPod. Inc.
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 I sign it of my own free will.
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