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PROGRAM REGISTRATION FORM

ADULT/GUARDIAN INFORMATION

WAIVER & RELEASE OF LIABILITY:

The above named participant has my permission to participate in the activity indicated above. I realize every precaution is taken to eliminate any injuries or hazards and a competent supervisor is present. However, in the event of an injury, I hereby waive, release, and hold harmless from any liability for damages or claims for damages for personal injury, including accidental death, as well as from claims for property damage which may arise in connection with the above named activity, against the Supervisor, Community & Library Services Department personnel, and the City of Huntington Beach. Participants of virtual recreation classes acknowledge they are responsible for ensuring their environment is safe/free from obstructions and that any use of third-party applications (e.g., Zoom, Instagram, etc.) is at their own security risk.

COVID-19 WAIVER:

I am aware of the COVID-19 pandemic and related governmental orders, directives and guidelines (collectively “directives”), including directives for frequent hand washing, social distancing and use of face masks in public locations. I am aware that this facility and the activity for which it is being used will be located in a public location during the COVID-19 pandemic. I am aware that I could be infected, seriously injured or even die due to COVID-19. I accept and voluntarily incur any and all risks or danger of bodily injury, death, property damage, loss, expense or harm which arise during or result from my use of the assigned facility/grounds, regardless of whether or not caused in whole or in part by the alleged or actual negligence of city of Huntington Beach, its officials, employees, representatives, and volunteers.

PHOTO RELEASE:

Registration constitutes permission for the City of Huntington Beach to take and use any photograph of the above named participant and/or legal guardian in any promotion materials without compensation to the above named participant and/or legal guardian of the above name participant for such use.

WITHDRAWAL & REFUND POLICY:

» Full refunds are available for classes that are cancelled by the City or instructor before the start of the first day. All other withdrawals are subject to a $6 processing fee for each class session.
» Refunds will not be issued after the commencement of the third class meeting.
» Refunds after the start of the program are contingent upon City approval and will be assessed a $6 processing fee and will be prorated based on the number of classes held. Credit card transactions will be refunded to the same credit card used for enrollment. Payments made by cash or check will be refunded in the form of a City-issued check.
» Refunds for workshops and camps must be requested a minimum of three business days in advance of the first day.

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July 25, 2024 8:01 am PDT

PROGRAM REGISTRATION FORM Uploaded by Christian Saenz - orangcountysurfcoaching@gmail.com IP 213.88.0.150