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In addition to the registered parent, the following individuals may pick up and drop off my children.
I, the undersigned as the parent and legal guardian of the child listed on this form, give permission for my child (children) to participate in the youth activities offered by Denver Country Club. I understand and acknowledge, in allowing my child to participate in these activities, that the risk of injury may exist and medical treatment may be necessary. I represent that my child is in excellent physical health and state further that there is no need to limit his or her activities or participation in the youth activities because of any physical condition or ailment. I assume full responsibility for my child’s (children's) physical condition and authorize Denver Country Club to include my child in all activities with full confidence in this statement. If my child’s (children's) physical condition changes after the time of this statement, I will notify Denver Country Club in writing. In the case of an emergency, I hereby give authorization to Denver Country Club, its employees, and the treating physician, to obtain whatever medical treatment deemed necessary for the immediate welfare of the child listed on this registration form. I represent that my child is currently covered under existing accident and health insurance policies and further state that I understand and agree that is my responsibility to pay for any and all charges for medical treatment for my child, regardless of whether my insurance covers such charges and fees.
I, the undersigned, as the parent or legal guardian of the child listed on this registration form, release Denver Country Club and its agents, employees, officers, directors, certificate holders, independent contractors, and successors, from all liability and claims of any nature which I may have as a result of injury or death of my minor child, occurring as a result of his or her participation in Denver Country Club’s youth activities or presence on Club property. I agree to indemnify Denver Country Club and its agents, employees, officers, directors, certificate holders, independent contractors, and successors, from all liability, claims, indebtedness, and expenses (including attorney’s fees) which are asserted or assessed as a result of or in connection with my minor child’s participation in Denver Country Club’s youth activities or his or her presence on Club property.
I have read, understand, and agree to the terms and conditions stated on this registration form as they relate to my child (children).
By signing my name on the line below and submitting electronically, it represents my signature and acceptance of the above Informed Consent, Release & Indemnity Agreement, and Conditions of Participation:
