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LEAP Liability Waiver

  1. Liability Waiver Header

  2. Virginia Rules : Law Enforcement Adventure Program (LEAP)

  3. Liability Waiver

  4. I, the undersigned participant/parent, request voluntary participation for minor to participate in the Louisa County Sheriff’s Office Virginia Rules: Law Enforcement Adventure Program (LEAP) June 17-21, 2019, which will begin each of the aforementioned days at 8:30am and ends at 5:00pm all of which are hereinafter referred to as the “activity”.

  5. I consent to my/minor’s participation in the activity and acknowledge that the minor and I fully understand my/minor’s participation may involve risk of serious injury or death. Including losses which may result not only from my/minor’s own actions, inactions or negligence, but also from the actions, inactions, or negligence of others, the condition of the facilities, equipment or areas where the event or activity is being conducted, and/or the rules of play of this type of event or activity. I understand that if I have any risk concerns, I should discuss the risks associated with my participation with the activity coordinators and instructors, before I sign this document and before the activity begins.

  6. I certify that my/minor is in good health and have not physical condition that would prevent participation in this activity. Furthermore, I agree to use my/minor’s personal medical insurance as a primary medical coverage payment if accident or injury occurs. I consent to emergency medical treatment in the event such care is required.

  7. Knowing and understanding the risks involved with participation in the activity, I hereby voluntarily and willingly assume responsibility for all risks and dangers associated with my/minor’s participation in the activity. I agree I am financially responsible for any losses resulting from my/minor’s action and will indemnify the County of Louisa, the officers, constitutional officers, directors, employees, volunteers, and agents of each of them, for any loss or damage caused by myself/minor during this activity.

  8. In consideration of my/minor’s participation in the activity, I hereby waive all claims or causes of action against the County of Louisa, the officers, constitutional officers, directors, employees, volunteers and agents of all of them arising out of my/minor’s participation in the activity and hereby release, hold harmless and discharge the County of Louisa, officers, directors, employees and agent of each of them from all liability in connection therewith except such loss or damage which was caused by the sole negligence or willful misconduct of the County of Louisa, it’s officers, employees, representatives, volunteers and the officers, directors, employees and agents of each of them.

  9. I have read this release of liability agreement and understand the terms used in it and their legal significance. This waiver and release is freely and voluntarily given with the understanding that right to legal recourse against the County of Louisa, officers, constitutional officers, directors, employees, volunteers and agent of each of them is knowingly given up in return for allowing my/minor’s participation in the activity. My signature on this document is intended to bind not only myself but also my successors, heirs, representative, administrators and assigns.

  10. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  11. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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