Brooklyn-Queens LEAH Brooklyn-Queens LEAH Brooklyn-Queens LEAH Brooklyn-Queens LEAH Brooklyn-Queens LEAH Brooklyn-Queens LEAH
 

BQ-LEAH Waiver and Release of Liability 2024-2025

indicates a required answer

1. *

Please enter the Primary Parent/Guardian's First and Last Name. Example Jane Doe.

The secondary parent/guardian is optional. Example would be Jane and John Doe.

 

The aforementioned parents/guardians, hereby authorize any members who are registered with my family and under my guardianship to attend and participate in any events and activities which Brooklyn-Queens LEAH (BQ-LEAH) has created, organized, scheduled, and/or assisted with during the current school year that runs from July 1 through June 30.

I, hereby freely and voluntarily release, both now and forever,  BQ-LEAH, its directors, teachers,  assistants, volunteers,  and chaperones, from any and all liability, claims, demands, and or suits for personal injury and or property damage which arise out of the participation of any member of my family in any events and/or activities, whether the personal injuries and or property damage results in whole or in part from any negligence of BQ-LEAH, its directors, teachers,  assistants, volunteers, and chaperones.  I understand and accept in making this release, that I am voluntarily waiving the right to assert a claim, suit, and or demand for any negligently caused personal injury and or property damage against BQ-LEAH, its directors, teachers, assistants, volunteers, and chaperones, regardless of whether the injury or property damage is said or believed to have been caused in whole or in part by them. I am aware of the risks and hazards involved in the activity.  

I understand that this release does not release or waive the right to assert any claims for personal injuries and or property damage against other persons and or entities, as a result of the negligence (in whole or in part) of those other persons or entities, in any combination.  

I attest that I am of legal age to execute this form as a binding legal document in accordance with its intention.

I hereby certify that I have fully read, understand, and agree to the terms and conditions of the BQ-LEAH Waiver and Release of Liability, and represent that I have the authority to execute the same on behalf of any members registered online with my family and under my guardianship.

 

Additional Liability Agreement concerning COVID-19: 

I and members of my family:

  • Acknowledge that my family's participation in BQ-LEAH events and activities could expose my family to a possible risk of personal injury, and to exposure to COVID-19, and that such injury, COVID-19 exposure, etc., could lead to illness, permanent injury or death, and that I assume all risks and accept sole responsibility that is inherent in such participation and/or utilization.
  • Release and agree to indemnify and hold harmless BQ-LEAH and any of its event locations, which includes its directors, teachers,  assistants, volunteers,  and chaperones from any and all liability, loss, damage, expense, or cost of any nature whatsoever from any and all claims by or against my family's participation and/or utilization, including claims that are known or unknown, foreseen or unforeseen, future on contingent.
2. *

I hereby certify that I have fully read, understand, and agree to the terms and conditions of the BQ-LEAH Waiver and Release of Liability.

Yes - I agree
3. *

Spouse agreement to the BQ-LEAH Waiver and Release of Liability

Yes - I agree N/A - single parent or guardian
4. *

A copy of your Waiver and Release of Reliability will be emailed to the address you list below.


5. Click the SUBMIT button below to complete and submit your form.