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application form

Assumption of Risk:

I understand that my child(ren), and each participant in the Camp, will be engaging in activities that may involve the risk of serious personal injury, illness, permanent disability, dismemberment, and death, and that also involve the risk of severe economic and property loss and damage. I understand that these risks may result from the actions, negligence, and failure to act of my child(ren) and others (including, but not limited to, other participants in Camp, and the organizers, employees, staff, counselors, and volunteers, if any, of the Camp) and the condition of any real or personal property, facilities, or equipment used during the Camp. I also understand that there may be risks involved in any and all activities which my child(ren) may participate which are not known to me, my child(ren), STEM Academy For Young Kids, or its organizers, directors, members, employees, staff, counselors, and volunteers, if any, and may not be foreseen or reasonably foreseeable by any of the foregoing entities or persons at this time or at the time of the Camp.

For my child(ren) at camp, these activities and associated risks may include time in the pool and transportation via motorized vehicle (shuttle, coach, and/or school bus) to and from camp and between different segments of the Camp during camp hours. Permission is granted to STEM Academy For Young Kids to transport my child(ren) via motorized vehicle to and from the Camp during camp hours and between different segments of the STEM Academy For Young Kids location/facility and any outside facilities used by STEM Academy For Young Kids during the Camp.

In consideration for my child(ren) being permitted to participate in the Camp, I, on behalf of my child(ren), assume all of the foregoing risks, including, but not limited to, the risk of any negligence by other Camp participants or by STEM Academy For Young Kids, and its respective owners, partners, directors, officers, employees, and agents, and the risk of injury caused by the condition of any real or personal property, facilities, or equipment used during the Camp, and accept personal responsibility for any injury (including, but not limited to, personal injury, disability, dismemberment, and death), illness, damage, loss, claim, liability, or expense (including reasonable attorneys’ and professionals’ fees), of any kind or nature, that my child(ren) or I may suffer arising out of or in any way connected with the Camp or my child(ren)’s participation in or attendance at the Camp.

Furthermore, I, on behalf of my child(ren) agree to indemnify and hold harmless STEM Academy For Young Kids and its owners, partners, directors, officers, employees, and agents from any claim that I might have arising out of my child(ren)’s participation in, transportation by, or involvement with the Camp.

I understand that my child(ren) are fully responsible for complying with all rules and regulations of the Camp and any motorized vehicle service and that STEM Academy For Young Kids reserves the right to cancel my child(ren)’s participation in the Camp or motorized vehicle service at any time.

I further understand that while STEM Academy For Young Kids will make every effort to minimize lost items at the Camp or on the motorized vehicle, STEM Academy For Young Kids is not responsible for any property left at the Camp or on the motorized vehicle.

I also understand that there will be specific and non-negotiable times for the departure and arrival of some STEM Academy For Young Kids transportation, and STEM Academy For Young Kids has the right to cancel my child(ren)’s participation in the motorized vehicle if these departure and arrival times are not respected.

I also agree that no general or limited partner, shareholder, director, officer, member, beneficiary, trustee, manager, other controlling person, investor, employee, attorney, agent, or independent contractor of STEM Academy For Young Kids (each an “Exculpated Person”) shall be personally liable for any obligation or liability of such party in connection with the Camp, and all obligations and liabilities of such party in connection with the Camp are enforceable solely against such party and such party’s assets, and not against any Exculpated Person or the assets of any Exculpated Person.

Liability Release and Indemnity Agreement:

I, on behalf of my child(ren), hereby release and forever discharge and agree to indemnify and save and hold harmless STEM Academy For Young Kids, Camp facility partners, the respective owners (direct and indirect) and each of their respective parents and affiliated and subsidiary companies, volunteers associated or affiliated with the Camp, and each of the aforementioned respective officials, owners, partners, directors, officers, employees and agents, and the other participants in the Camp (each such entity or individual being referred to as a “Released Party”), of and from any and all injuries (including personal injury, disability, dismemberment, and death), illness losses, damages, claims, liabilities, or expenses of any kind or nature (and whether accruing to me, my child(ren), my heirs, or my personal representatives) that are caused or alleged to be caused in whole or in part by the action, negligence, or failure to act by any Released Party or condition of any real or personal property, facility, or equipment of any Released Party, and that arise out of or are in any way connected with any aspect of the Camp or my child(ren)’s participation therein or attendance thereat.

I acknowledge that, in the event of any breach by STEM Academy For Young Kids, or any third party, the damage, if any, caused me or my child(ren) thereby will not be irreparable or otherwise sufficient to entitle me or him/her/them to seek injunctive or other equitable relief, and my child(ren) and I will be strictly limited to the right, if any, to recover damages in an action at law. Neither my child(ren) nor I will have either the right to rescind or terminate this waiver and release or any of STEM Academy For Young Kids’s rights hereunder, or the right to enjoin the production, exhibition, or other exploitation of my child(ren)’s name, voice, and likeness, or any subsidiary or allied rights with respect thereto.

Severability of Provisions:

I have carefully read the entirety of this waiver and release and agree to all its terms and conditions. I represent that I am the parent, legal guardian or empowered representative of the minor child(ren) in the registration form with the authority to give this waiver and release, and I hereby agree that both my child(ren) and I shall be bound hereby. I agree that the foregoing terms and conditions are intended to be as broad and inclusive as is permitted by law, and any terms and conditions set forth herein found by a court to be void or unenforceable shall not affect the validity or enforceability of any other terms and conditions. This waiver and release will inure to the benefit of and will be binding upon both my, my child(ren)’s, STEM Academy For Young Kids’s respective affiliates, successors, licensees, assigns, heirs, and representatives. The validity, construction and enforceability of this waiver and release shall be governed by, and construed and interpreted in accordance with NJ State Law.

Conclusion :

I have carefully read the entirety of this waiver and release and agree to all its terms and conditions. Knowing all of these facts and in consideration for your accepting my child(ren)’s enrollment form/online registration and for being allowed to participate in the Camp, I, for myself, my child(ren) attending the camp, and anyone else who may claim on me or my child(ren)’s behalf (“I”) hereby agree that neither STEM Academy For Young Kids and/or the schools or facilities that host the Camp, are responsible for accidents, injuries, and/or medical or dental expenses arising from my child(ren)’s participation at the Camp and, accordingly, I covenant not to file suit against or otherwise sue STEM Academy For Young Kids, and waive, release, and discharge STEM Academy For Young Kids and the various schools or facilities that host the Camp, and anyone working on their behalf from any and all claims of liability or expenses of any kind or nature whatsoever arising out of or relating to my child(ren)’s participation in the Camp.

Camper 1 Name :

Camper 2 Name :

Camper 3 Name :

Parent / Empowered Representative Signature :

Printed Name :

Relationship to Minor Child :

Date :