Form Center

2. Waiver, Release and Consent to Medical Treatment

   I hereby, for myself, and my heirs, agree as follows:

                   1.  I acknowledge and understand that programs of this nature involve risks of personal injury and property damage, and that as a prerequisite to participate in a program of this nature, I am required to assume all such risks.  I acknowledge and understand that the goal of the City of San Marcos Parks and Recreation Department is to facilitate safe and enjoyable programs for all participants; the City does not guarantee the safety of participants.

                   2. I knowingly and voluntarily waive and release all rights and claims for any and all damages and injuries I may have against the City of San Marcos and its officers, agents and employees in connection with the Fall Carnival of the City’s Parks and Recreation Department.

                   3. I give permission to the City to use my photograph or image with or without my name for any and all purposes, including, but not limited to, private or public presentations, advertising, publicity and promotional activity.  I warrant that I have the right to authorize the foregoing uses and do hereby agree to hold the City of San Marcos Parks and Recreation Department harmless of and from any and all liability of whatever nature which may arise out of result from such uses.

                   4. In the event of an accident or illness, I give permission to the City of San Marcos and its officers, agents and employees to obtain medical treatment that may reasonably appear to be necessary in the course of my participation in this program if I am unable to make that decision.

4. First and Last Name/Parent Guardian*
6. Children/Dependents
8. Name of Organization
10. All volunteers must sign. By signing below, you agree to the statements listed above.*
Leave This Blank:


11. Submit

* indicates a required field