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2. 
4. Outdoor Adventures Programs
   Thank you for your interest in Dallas Park and Recreation Department's Outdoor Adventures Family Programs.
6. Participant Information
8. Parent / Guardian Name*
9. Date of Birth*
10. Age
12. Household Participant Name
13. Date of Birth
14. Age
16. Household Participant Name
17. Date of Birth
18. Age
20. Household Participant Name
21. Date of Birth
22. Age
24. Household Participant Name
25. Date of Birth
26. Age
28. Household Participants Name
29. Date of Birth
30. Age
34. Household Information
36. Initials*
    Type your initials in the box acknowledging and agreeing to the statement.
37. I understand all participating members must reside within the same household, defined as living together within the same dwelling. I understand the parent/guardian of the household must be an active participant.
39. Street Address
41. City
42. State
43. Zip
45. Parent / Guardian Phone Number*
46. Parent / Guardian Email Address
48. Emergency Contact Name*
49. Emergency Contact Phone Number*
53. Functional Criteria & Eligibility Standards for Participation
55. I understand all registered participants must meet the minimum age requirements and activity requirements.*

    1. I Agree
57. I understand all registered participants must maintain at least 6-feet between members of my household and other park users and staff.*

    1. I Agree
59. I agree to wash or disinfect hands after any interaction with employees, other customers, or items in the park.*

    1. I Agree
61. I understand Dallas Park and Recreation Staff may discontinue the activity at any time if participants are behaving in an unsafe manner or jeopardizing the safety of staff or other participants.*

    1. I Agree
63. I understand all registered participants must self-screen before going to a park or other public open space for new or worsening signs or symptoms of possible COVID-19. *

    1. I Agree

    (COVID19 Signs/symptoms - Cough; Shortness of breath or difficulty breathing; Chills, or repeated shaking with chills; Muscle pain; Headache; Sore throat; Loss of taste or smell; Diarrhea; Feeling feverish or a measured temperature greater than or equal to 100.0 degrees; Known close contact with a person who is lab confirmed to have COVID-19)
67. Waivers & Signatures
69. Initials*
    Type your initials in the box acknowledging and agreeing to all City of Dallas waivers.
70. Exculpatory Clause
    EXCULPATORY CLAUSE. In consideration for receiving permission for my participation in any and all activities associated with senior medical transportation activity as a guest of the City of Dallas (hereafter referred to as “activity”) and deriving benefits from such activity, which is sponsored by the City of Dallas, I hereby release, waive, discharge, covenant not to sue, and agree to hold harmless for any and all purposes the City of Dallas, its City Council and its members, its boards and commissions and their members, its officers, employees, servants, agents, consultants and volunteers (collectively herein referred to as CITY) from any and all liabilities, claims, demands, injuries (including death), or damages, including court costs and attorney’s fees and expenses, that may be sustained by me while participating in the activity, while traveling to and from the activity, or while on the premises owned or leased by the CITY, or otherwise in the care of staff members, including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of the CITY. I understand this waiver does not apply to injuries caused by intentional or grossly negligent conduct.
72. Initials*
    Type your initials in the box acknowledging and agreeing to all City of Dallas waivers.
73. Indemnity Clause
    INDEMNITY CLAUSE. I am fully aware that there are inherent risks to myself and others involved with the activity, including but not limited to unintentional collision injuries like broken bones, concussions, permanent injury or possible death, and I choose to voluntarily participate in the activity with full knowledge that the activity may be hazardous to me and my property, and to the person and property of others. I know of no medical reason why I should not participate. I agree to indemnify and hold harmless the CITY, as well as their officers, agents, employees, consultants and volunteers of the activity from any and all liabilities, claims, demands, injuries (including death), or damages, including court costs and attorney’s fees and expenses, which may occur to myself, other participants, and third-persons as a result of my participation in the activity, including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of the CITY.
75. Initials*
    Type your initials in the box acknowledging and agreeing to all City of Dallas waivers.
76. No Insurance Clause
    NO INSURANCE. I understand that the CITY may or may not maintain any insurance policy covering any circumstance arising from my participation in the activity or any event related to that participation. As such, I am aware that I should review my personal insurance coverage. The CITY may not carry general liability insurance to cover claims arising from the activity so it seeks a waiver of claims as additional consideration for the right to participate so the CITY can: (a) provide the activity at the lowest possible cost to participants; and (b) provide access to a greater number of participants by expending limited resources on the activity rather than on liability insurance.
78. Initials*
    Type your initials in the box acknowledging and agreeing to all City of Dallas waivers.
79. Binds Heirs Clause
    BINDS HEIRS. It is my express intent that this agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be governed by the laws of the State of Texas.
81. Initials*
    Type your initials in the box acknowledging and agreeing to all City of Dallas waivers.
82. Medical Authorization Clause
    MEDICAL AUTHORIZATION, INDEMNITY FOR MEDICAL EXPENSES, and WAIVER. I understand the CITY cannot be expected to control all of the risks articulated in this form and the CITY may need to respond to accidents and potential emergency situations. Therefore, I hereby give my consent for any medical treatment that may be required, as determined by a medical professional at the medical facility, during my participation in the activity with the understanding that the cost of any such treatment will be my responsibility. I agree to indemnify and hold harmless the CITY, its officers, agents, and employees, for any costs incurred to treat me, even if the CITY has signed hospital documentation promising to pay for the treatment due to my inability to sign the documentation. I further agree to release, waive, discharge, covenant not to sue, and agree to hold harmless for any and all purposes the CITY from any and all liabilities, claims, demands, injuries (including death), or damages, including court costs and attorney’s fees and expenses, that may be sustained by me while receiving medical care or in deciding to seek medical care, including while traveling to and from a medical care facility, including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of the CITY. I understand this waiver does not apply to injuries caused by intentional or grossly negligent conduct.
84. Initials*
    Type your initials in the box acknowledging and agreeing to all City of Dallas waivers.
85. Photograph Release
    RELEASE OF PHOTOGRAPHS/VIDEO/AUDIO. I expressly give and grant to the CITY the unqualified right, privilege, and permission to reproduce, publish, and circulate in every manner or form (including radio, television, newspapers, magazines, and the internet) video tapes, films, photographs, transparencies, and other images and likenesses of me, my child(ren), family, and/or property and audio recordings of my and their voices (collectively referred to as “video and audio recordings”) , and I hereby grant, assign and transfer to the CITY all rights and interest therein at no charge. I specifically authorize and empower the CITY to cause any such video and audio recordings, to be copyrighted or in any other manner to be legally registered in the name of the CITY. I, for myself, my family, my child(ren), my heirs, executors, administrators and assigns, hereby remise, release, and discharge the CITY from any and all claims of any kind due to the use of such video and audio recordings, including all claims for damages or injunctive relief for libel, slander and invasion of the right of privacy.
87. Initials*
    Type your initials in the box acknowledging and agreeing to all City of Dallas waivers.
88. Voluntary Signature
    VOLUNTARY SIGNATURE. In signing this agreement, I acknowledge and represent that I have read it, understand it, and sign it voluntarily as my own free act and deed; the CITY has not made and I have not relied on any oral representations, statements, or inducements apart from the terms contained in this agreement. I execute this document for full, adequate, and complete consideration fully intending to be bound by the same, now and in the future. I understand I can choose not to sign this document and free myself from its terms and the associated risks of the activity by simply not participating in the activity and choosing some other activity available to me that has a lower level of risk to myself. I further understand this activity is voluntary and extracurricular. While I understand alternative activities are available to me that do not have the risks associated with the activity, I still desire to voluntarily engage in the activity.
90. Signing this document involves the waiver of valuable rights. Consult your attorney before signing this document.
91. Signed on this date:
93. Electronic Signature Agreement*

    1. I Accept

    By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and the City of Dallas. You are also confirming that you are the person authorized to enter into this Agreement.
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