MCWS LIABILITY/CONSENT WAVIER FORM
Muslim Community of Western Suburbs
40440 Palmer Rd, Canton, MI 48188
Event/Activity: MCWS Middle School Summer Camp (June 20th-22nd, 2025)
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I, the undersigned parent or legal guardian, acknowledge that my child is voluntarily participating in activities organized by the Muslim Community of Western Suburbs (MCWS) and/or Medina Activity Center (MAC), that involves inherent risks, including, but not limited to physical injury, illness, or property damage.
I hereby RELEASE, WAIVE, DISCHARGE, and agree NOT TO SUE MCWS or MAC, and its board members, trustees, officers, volunteers, employees, and affiliates (collectively referred to as "RELEASEES") from any and all claims, liabilities, demands, actions, or causes of action arising out of any injury, loss, or damage—including serious injury or death—that may occur to my child while participating in these activities or while on the premises where they are conducted.
I understand and agree that this waiver extends to any injuries or damages that may result from the ordinary negligence of MCWS, MAC and its representatives. I also agree that this release and waiver applies to me, my child, and our heirs, assigns, and personal representatives.
Further, I give MCWS/MAC permission to take and use photos/videos of my child for promotional purposes.
By signing below, I acknowledge that I have read and understood this Liability Waiver and Hold Harmless Agreement. I am signing it voluntarily and with full knowledge of its implications.
CAMP WILLSON LIABILITY/CONSENT WAVIER FORM
Event/Activity: MCWS Middle School Summer Camp (June 20th-22nd, 2025)
IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA FOR ANY PURPOSE CONSISTENT WITH THIS AGREEMENT, INCLUDING BUT NOT LIMITED TO EVALUATION OR USE OF FACILITIES OR EQUIPMENT, THE USER HEREBY AGREES TO THE FOLLOWING:
1. THE USER HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the YMCA, its directors, officers, employees, and agents (hereinafter referred to as “releases”) from all liability to the User, its employees, agents, personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefore on account of injury to person or property or resulting in death of the User, whether caused by the negligence of the releases or otherwise while the User or its employees, clients, agents, or representatives are in, upon, or about the premises including use of any facilities or equipment therein.
2. THE USER HEREBY AGREES TO INDEMNIFY, DEFEND, SAVE, AND HOLD HARMLESS the releases and each of them from any loss, liability, damage, or cost they may incur arising from the user's operations at the YMCA premises, including but not limited to use of YMCA's equipment or facilities, regardless of whether such harm is caused by the sole or partial fault of the releases.
3. THE USER HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE that may be incurred arising from the User's operations at the YMCA premises, including but not limited to use of YMCA's equipment or facilities, regardless of whether such harm is due to the sole or partial fault of the releases.
4. THE USER further expressly agrees that the forgoing RELEASE, WAIVER, AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the law of the State of Ohio and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect
Medical Release and Authorization
As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
Permission is also granted to the Camp Willson, and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.
Release authorized on the dates and/or duration of the registered season.
This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.