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<body class='hmmessage'><div dir='ltr'>Here is a sample from my City attorney days:<div><br></div><div><br></div><div><p style="font-family: 'Times New Roman'; font-size: medium;">PASCO RECREATION RELEASE AND CONSENT AGREEMENT</p><p style="font-family: 'Times New Roman'; font-size: medium;"></p><p style="font-family: 'Times New Roman'; font-size: medium;">IN CONSIDERATION of being permitted to take part in the following City of Pasco recreational activity: _____________________________________________, hereinafter referred to as the “Activity”, I, for myself, my heirs, personal representatives, assigns or for the below named minor, do hereby release, waive, discharge, and covenant not to sue CITY OF PASCO, WASHINGTON, a Municipal Corporation, its officers, employees, agents, event sponsors, partners, and volunteers (collectively: “City and Sponsors”) for liability from any and all claims including the negligence of the City and Sponsors, resulting in personal injury, accident, illness, or death and property loss arising from, but not limited to, participation in the Activity.</p><p style="font-family: 'Times New Roman'; font-size: medium;">ASSUMPTION OF RISK: Participation in the Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks may vary from one activity to another, but the risks range from (1) minor injuries such as scratches, bruises, and sprains; (2) major injuries such as joint or injuries to the extremities, heart attack and concussions; and (3) catastrophic injuries including paralysis and death. I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in the Activity. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.</p><p style="font-family: 'Times New Roman'; font-size: medium;">INDEMNIFICATION AND HOLD HARMLESS: I also agree to INDEMNIFY, DEFEND, AND HOLD the City and Sponsors HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney's fees and costs brought as a result of my involvement in the Activity and to reimburse them for any such expenses incurred.</p><p style="font-family: 'Times New Roman'; font-size: medium;">MEDICAL CONSENT: I hereby give my consent for emergency medical treatment for myself, or for the below named minor, including, but not limited to, ambulance service, emergency responder service, and medical care by licensed medical staff or physicians. I understand that I will be fully financially responsible for said medical care and that the medical care may be necessary to prevent undue delay in receiving treatment.</p><p style="font-family: 'Times New Roman'; font-size: medium;">PHOTOGRAPHY: I consent that photographs and video of myself, or the below named minor, may be taken and used for publicity purposes.</p><p style="font-family: 'Times New Roman'; font-size: medium;">SEVERABILITY: The undersigned further expressly agrees that the foregoing agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Washington and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.</p><p style="font-family: 'Times New Roman'; font-size: medium;">ACKNOWLEDGEMENT: I have read this agreement and fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing this agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. I am at least eighteen (18) years of age and fully competent (or I am the legal parent or guardian acting on behalf of a minor); and I execute this Release for full, adequate and complete consideration fully intending to be bound by the same.</p><p style="font-family: 'Times New Roman'; font-size: medium;"></p><p style="font-family: 'Times New Roman'; font-size: medium;">DATED this ____ day of ______________, 2011.</p><p style="font-family: 'Times New Roman'; font-size: medium;"></p><p style="font-family: 'Times New Roman'; font-size: medium;">__________________________________________ _____________________________________________</p><p style="font-family: 'Times New Roman'; font-size: medium;">Signature of Participant Print Name of Participant</p><p style="font-family: 'Times New Roman'; font-size: medium;"></p><p style="font-family: 'Times New Roman'; font-size: medium;">__________________________________________ _____________________________________________</p><p style="font-family: 'Times New Roman'; font-size: medium;">Signature of Parent/Guardian on behalf of Participant Print Name of Parent/Guardian</p><p style="font-family: 'Times New Roman'; font-size: medium;"></p><p style="font-family: 'Times New Roman'; font-size: medium;">______________________________________________ _____________________________________________</p><p style="font-family: 'Times New Roman'; font-size: medium;">Emergency Contact Name Emergency Contact Phone Number(s)</p><p style="font-family: 'Times New Roman'; font-size: medium;"></p><p style="font-family: 'Times New Roman'; font-size: medium;">Please list all medications and conditions emergency responders should be aware of: __________________________________________________________________________________________________________________________________________________________________________________________</p><p style="font-family: 'Times New Roman'; font-size: medium;"></p><p style="font-family: 'Times New Roman'; font-size: medium;">IMPORTANT - - - THIS IS A RELEASE OF LIABILITY</p><br><p class="ecxMsoNormal"><strong><font color="#000000">Patrick J. Galloway</font></strong></p><p class="ecxMsoNormal"><font color="#000000">Advance Legal Services, PLLC</font></p><p class="ecxMsoNormal"><font color="#000000">8113 W. Quinault Ave. Suite 101</font></p><p class="ecxMsoNormal"><font color="#000000">Kennewick, WA 99336</font></p><p class="ecxMsoNormal"><font color="#000000"> </font></p><p class="ecxMsoNormal"><font color="#000000">(509) 851-7884</font></p><p class="ecxMsoNormal"> </p><p class="ecxMsoNormal"> <a href="http://www.alsnorthwest.com" target="_blank">www.alsnorthwest.com</a></p><p class="ecxMsoNormal"> </p><p class="ecxMsoNormal">This E-Mail message and any documentation accompanying this transmission may contain privileged and/or confidential information and is intended solely for the addressee(s) named above. If you are not the intended addressee/recipient, you are hereby notified that any use of, disclosure, copying, distribution, or reliance on the contents of this E-Mail information is strictly prohibited and may result in legal action against you. Please reply to the sender advising of the error in transmission and immediately delete/destroy the message and any accompanying documents. Thank you.</p><p class="ecxMsoNormal"><br></p><p class="Body" style="color:rgb(68, 68, 68);font-size:15px;background-color:rgb(255, 255, 255);">*_Important Disclosures Regarding Email Communications_*</p><p class="Body" style="color:rgb(68, 68, 68);font-size:15px;background-color:rgb(255, 255, 255);">Advisory services through Retirement Wealth Advisors, Inc., a SEC Registered Investment Advisor. This Email is being sent by or on behalf of a Registered Investment Advisor. It is intended exclusively for the individual or entity to which it is addressed. This communication may contain information that is proprietary, privileged, or confidential, or otherwise legally exempt from disclosure. If you are not the named addressee, you are not authorized to read, print, retain, copy or disseminate the Email or any part of it. If you have received this Email in error, please notify the sender immediately by Email or fax, and destroy all copies of this communication. Please be advised that you may conduct securities transactions only by speaking directly with your Investment Advisor Representative either by phone or in person. Requests for securities transactions via email will not be executed by Retirement Wealth Advisors, Inc. To help protect your privacy, we strongly suggest you avoid sending sensitive information, such as account numbers and social security numbers via Email.<span style="line-height:21.2999992370605px;"> </span>Please be further advised that, pursuant to the Bank Secrecy Act, the USA PATRIOT ACT, and similar laws, any communication in this email is subject to regulatory, supervisory, and law enforcement review.</p><div><br></div><br><br><div><hr id="stopSpelling">From: pneumiller@hotmail.com<br>To: wsbapt@lists.wsbarppt.com<br>Date: Fri, 19 Jun 2015 16:05:10 -0700<br>Subject: [WSBAPT] Health Care DPOA for Minors<br><br><style><!--
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--></style><div class="ecxWordSection1"><p class="ecxMsoNormal">Interesting Situation. I mountain bike with a large group of people every week (over 40 people have shown up in the past. Ages 5 through 74.) The owner of the property (deep pockets) where we ride a part of the time is concerned when a parent drops off a minor to ride with us. While he has not asked anyone to sign a release in case anyone gets hurt on his property (though I have repeatedly advised him to consult with his army of attorneys), he is concerned that if a minor gets hurt on his property (or, even off his property), no one can authorize medical treatment in case an adult has to drive the kid to the hospital (we have had two broken arms/wrists in the last two months). Some of the attending adults who know the kids are willing to be designated under a DPOA for Health Care for a Minor. </p><p class="ecxMsoNormal"> </p><p class="ecxMsoNormal">Anyone have an appropriate form under these circumstances? </p></div><br>_______________________________________________
WSBAPT mailing list
WSBAPT@lists.wsbarppt.com
http://mailman.fsr.com/mailman/listinfo/wsbapt</div></div> </div></body>
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