(Please fill out a separate form for each child)
I understand the nature of the activities that my child will be participating in during the week/s of July 17th or July 24th, 2017, at the Riverside County, Western Riverside Animal Shelter during Critter Kiddz Camp. I also understand the nature of domestic animals and that their behavior is sometimes unpredictable which can give rise to risks such as personal injury. Knowing this, I, and anyone who might claim on my behalf, release the Department of Animals Services, the ASK Foundation, the County of Riverside, its Agencies, Districts, Special Districts, and Departments, their respective directors, officers, Board of Supervisors, employees, elected or appointed officials, agents or representatives from any and all claims and liability of any kind arising out of personal injury and property damage resulting from my child’s participation in activities during Critter Kiddz Camp.
In the event that my child requires medical attention, I authorize Riverside County Department of Animal Services to seek proper medical help at my cost.
I have listed below all of my child’s known allergies, all of my child’s physical limitations and any special needs that my child might have. In addition, I have no knowledge of any medical condition that would prevent my child from participating in the activities at Critter Kiddz Camp.
By signing this form, I grant the right to photograph, reproduce, and use said child’s artwork, written work, picture, silhouette, and other reproductions of physical likeness in connection with Riverside County Department of Animal Services’ and the ASK Foundation’s promotions.
By filling out this form and entering my name below, I have read, understand and agree with the statements above.