PARENT(S)/GUARDIAN(S)
CONSENT AGREEMENT & MEDICAL RELEASE FOR SKI TRIPS
[Please read carefully!]
TRIP PARTICIPANT NAME:_______________________________________________
DOB:___________ Trip Dates:
____________
Acct#:
_______________________ School/Group:
_______________________________
I/We certify that I/We am/are the
parent(s)/legal guardian(s) of the trip participant identified above (the
"Participant") who is participating in a trip (the "Trip")
arranged by STUDENTCITY.COM, Inc d/b/a
GRADCITY.COM or EPIC SKI (herein collectively referred to as “SCC”). I/We give
permission for the Participant to take part in the Trip, and agree to him/her
taking part in all activities which may be offered during the course of the Trip,
and give consent for him/her to take part in the activities offered.
I/We have been advised by SCC and understand
that SCC has hired staff to accompany trip participants on the Trip and that
such staff is being provided by SCC for general assistance and informational
purposes only. They are not chaperones or temporary guardians. I/We have read
and understand this form, along with the terms and conditions set forth in the brochure
and on the website for the specified Trip ("the Terms and
Conditions"). Without in any way limiting the applicability of the Terms
and Conditions, I/We understand that by agreeing to the Terms and Conditions
and signing this Form, I/We have agreed to limit SCC’s liability for personal
injury, property damage, and other harms to the Participant that may occur in
connection with SCC’s services. I/ We also understand that I/we have agreed to
release SCC from certain liabilities as previously stated herein and in the
Terms and Conditions and that I/we have agreed to reimburse SCC for any
emergency expenses with SCC may incur for the benefit of the Participant. I/We
have advised the Participant of the above information and give our assurance
that he/she understands the rules and consequences of their actions. I/We give
my/our consent for the Participant to participate in the Tour. To the extent
permitted by law I/We agree to indemnify and hold harmless SCC, its
subsidiaries and/or affiliates, its directors, officers, shareholders,
employees, agents, and their assistants and representatives from any and all
claims made under any theory of liability asserted at any time now or in the
future by a minor or otherwise for whom I/we as the parent(s)/guardian(s) sign
this release. I/We give my/our permission to SCC’s staff and/or available medical
personnel to authorize emergency medical treatment to Participant in the event
of an emergency. I/we understand that SCC will not tolerate any behavior by the
Participant which is deemed inappropriate to the vendor during the set dates of
the trip.
RESPONSIBILITY: I.WE UNDERSTAND AND AGREE THAT ALL TRAVEL
ARRANGEMENTS INCLUDED IN THIS TRIP ARE MADE ON BEHALF OF THE PARTICIPANT UPON
THE EXPRESS CONDITION THAT NEITHER SCC NOR ITS OWNERS, EMPLOYEE, OFFICERS OR
AGENTS SHALL BE LIABLE OR RESPONSIBLE FOR ANY NEGLIGENT OR WILLFUL ACT OR
FAILURE TO ACT OF ANY THIRD PARTY, SUCH AS OPERATORS OF AIRCRAFT, TRAINS, MOTOR
COACHES, PRIVATE CARS, CRUISE VESSELS, BOATS, SHIPS OR ANY OTHER CONVEYANCE,
HOTELS, SIGHTSEEING EXCURSIONS, LOCAL GROUND HANDLING, ETC. WHICH ARE TO OR DO
SUPPLY ANY GOODS OR SERVICES FOR THE TRIP. I/WE FURTHER UNDERSTAND THAT SCC
NEITHER OWNS NOR OPERATES SUCH THIRD PARTY SUPPLIERS AND ACCORDINGLY AGREE TO
SEEK REMEDIES DIRECTLY AND ONLY AGAINST THOSE SUPPLIERS AND NOT HOLD SCC
RESPONSIBLE FOR THEIR ACTS OR OMISSIONS.
WITHOUT LIMITATION, SCC IS NOT RESPONSIBLE FOR ANY NEGLIGENT OR WILLFUL
ACTS OR CRIMINAL ACTS OF OTHERS, INCLUDING BUT NOT LIMITED TO OTHER TRIP
PARTICIPANTS OR FOR ACTS OF GOD OR FORCE MAJEURE, WEATHER EMERGENCIES,
BREAKDOWN, OR FAILURE OF MECHANICAL EQUIPMENT, GOVERNMENT ACTIONS, INCLEMENT
WEATHER, SICKNESS, ATTACKS BY ANIMALS, AVAILABILITY OF MEDICAL CARE OR THE
ADEQUACY OF THE SAME, CRIMINAL ACTIVITY OF ANY KIND, THREAT OF TERRORISM,
TERRORISM, WAR, CIVIL DISTURBANCE, FIRE, SANITARY CONDITIONS, QUALITY OR
SANITATION OF FOOD, QUARANTINE, CUSTOMS REGULATIONS, EPIDEMICS, STRIKES, HOTEL
OVERBOOKING, SAFETY AND/OR SECURITY STANDARDS AT HOTELS OR OTHER
ACCOMMODATIONS, ANY PROBLEMS OR INJURIES WHATSOEVER ARISING FROM CUSTOMERS’
CONSUMPTION OF ALCOHOLIC BEVERAGES OR ILLEGAL DRUGS OR FOR ANY OTHER REASON
BEYOND THE CONTROL OF SCC, AND I/WE UNDERSTAND, AGREE WITH, AND AGREE TO BE
LEGALLY BOUND BY THE TERMS AND CONDITIONS OF THE TRIP AND THIS CONSENT
AGREEMENT AND MEDICAL RELEASE.
ACKNOWLEDGMENT OF RISK: I/We understand and acknowledge that the
Participant's participation in the Trip arranged by SCC may involve risk and
potential exposure to injury and possibly death. I/We specifically acknowledge and recognize
the potential for injury and death which can result from the Participant's, or
other people's, irresponsible and immature use of alcohol and/or illegal drugs in
connection with or during this Trip. I/We also realize and acknowledge that
risk and dangers may be caused by the negligence of the owners, employees,
officers or agents of SCC or the negligence or participation of other
participants, contractors and/or subcontractors to SCC. I/We also recognize and
acknowledge that risk and dangers may arise from foreseeable and unforeseeable
causes, including weather and other acts of nature. I/We fully understand and
acknowledge that the aforementioned risks, dangers and hazards are a potential
in connection with recreational activities which may take place during the
Trip.
ACTIVITY RELATED TRIPS & EXCURSIONS
(SKIING, SNOWBOARDING, ETC.)
I
understand that skiing, snowboarding, and other winter sports (the
“activities”) can be dangerous and involve inherent and other risks of injury
and death. Despite the risks involved in the activities, and as consideration
for being allowed to participate in the activities, I AGREE TO EXPRESSLY ASSUME ANY AND ALL RISK OF INJURY OR DEATH
that might be associated with my participation in the activities and use of the
corresponding facilities, including use of terrain parks, chairlifts, rental
equipment, instruction, racing, traveling beyond the ski area boundaries, and
all special events (collectively, “use of the facilities”). I understand that I
may encounter various manmade and natural terrain features during participation
in the activities or use of the facilities. I understand that I must inspect
the elements and terrain before I ski or ride over them to evaluate the risks
and degree of difficulty before participating. I understand that throughout the
day snow conditions and terrain features will change. I also understand that
weather conditions can change which in turn presents risk of snow, avalanche
and other dangerous conditions; regarding which, I assume all risk of injury. I
further understand that there is a risk that I could strike other people or
trees or other inanimate objects. I assume all risk of injury in this situation
as well.
RELEASE OF LIABILITY: In consideration of the services and
arrangements provided by SCC, I/We, for myself/ourselves, on behalf of the
Participant and for my/our heirs, personal representatives or assigns, do
hereby release, waive, discharge, hold harmless and agree to indemnify SCC, and
its owners, officers, directors, agents and employees from any and all claims,
actions, or losses for bodily injury, property damage, wrongful death, loss of
services, lost profits, consequential,
exemplary, indirect or punitive damages or otherwise which may arise out of or
occur during the Participant's travel in connection with the scheduled Trip and
any activities conducted in conjunction therewith.
I/WE SPECIFICALLY UNDERSTAND THAT I AM/WE ARE
RELEASING, DISCHARGING AND WAIVING ANY CLAIMS OR ACTIONS THAT I MAY HAVE
PRESENTLY OR IN THE FUTURE FOR THE NEGLIGENT ACTS OR CONDUCT OF THE OWNERS,
OFFICERS, EMPLOYEES, AGENTS OF SCC OR ANY CLAIM DISCUSSED OR REFERENCED IN THE TERMS AND CONDITIONS OR
HEREIN.
EXPRESS WAIVER OF ANY RIGHT TO SEEK
CONSEQUENTIAL, PUNITIVE OR EXEMPLARY DAMAGES:
Regardless of the situation or circumstances giving rise to a claim,
I/We waive any right to seek consequential, punitive or exemplary damages
against SCC, its owners, officers, directors, agents and employees, for any
reason whatsoever.
MEDICAL AUTHORIZATION: I/We hereby grant to
SCC and its staff full and complete power and authority with full power of
delegation and substitution, to do, execute, and perform any act, matter or
thing in connection with, arising out of, or necessary for any medical issues
or any other medical treatment regarding the Participant, which may arise during
the Trip in the absence of the undersigned, including, but not limited to,
making decisions affecting the Participant's medical care during the Trip and/or
for available medical personnel to provide emergency medical treatment to the Participant
in the event of an emergency. In addition, there are no serious medical or
health situations that would cause the Participant not to be able to
participate on the Trip. Any special circumstances will be noted will be listed
below that do not require further assistance.
MEDICAL EXPENSES: The Participant is
covered by medical insurance or, in the absence of such coverage; I/We agree to
pay all costs of rescue and/or medical services as may be incurred by the
Participant or on the Participant's behalf during such Trip.
SEVERABILITY:
The invalidity or unenforceability of any part of this Agreement,
or the invalidity of its application to a specific situation or circumstance,
shall not affect the validity of the remainder of this Agreement, or its
application to other situations or circumstances. Any provision of this Agreement held invalid
or unenforceable only in part or degree will remain in full force and effect to
the extent not held invalid or unenforceable.
CONFLICT: In the event of any inconsistency or
conflict between the terms of this Consent Agreement and Medical Release and
any terms or conditions otherwise applicable to the Trip, the terms of this
Consent Agreement and Medical Release shall prevail.
ARBITRATION: I/WE agree that any
dispute concerning, relating, or referring to the trip, this CONSENT AGREEMENT
AND MEDICAL RELEASE, or any other literature concerning the trip shall be
resolved exclusively by binding arbitration in the Commonwealth of
Massachusetts, according to the then existing commercial rules of the American
Arbitration Association. Such proceedings will be governed by substantive
Massachusetts law.
WAIVER OF
JURY TRIAL: IN CONNECTION WITH ANY ACTION OR LEGAL PROCEEDING ARISING OUT OF
THIS AGREEMENT, THE PARTIES HEREBY SPECIFICALLY AND KNOWINGLY WAIVE ANY RIGHTS
THAT EITHER PARTY MIGHT HAVE TO DEMAND A JURY TRIAL.
EXCLUSIVE
GOVERNING LAW AND EXCLUSIVE JURISDICTION: IF THE RIGHT TO SEEK
ARBITRATION IS FOR ANY REASON WAIVED BY BOTH PARTIES, THIS AGREEMENT AND ANY
ACTIONS AND PROCEEDINGS BROUGHT HEREUNDER OR RELATED THERETO SHALL BE GOVERNED
BY THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS, WITHOUT REGARD TO CONFLICTS
OF LAWS PRINCIPLES. ANY ACTION OR LEGAL
PROCEEDING TO ENFORCE ANY PROVISION OF, OR BASED ON ANY RIGHT ARISING OUT OF,
THIS CONSENT AGREEMENT AND MEDICAL RELEASE SHALL BE
BROUGHT EXCLUSIVELY IN THE COURTS OF MASSACHUSETTS OR, IF IT HAS OR CAN ACQUIRE
JURISDICTION, IN THE UNITED STATES DISTRICT COURT FOR MASSACHUSETTS, AND ALL OF
THE PARTIES HERETO HEREBY CONSENT TO THE EXCLUSIVE JURISDICTION OF SUCH COURTS
AND OF THE APPROPRIATE APPELLATE COURTS IN ANY SUCH ACTION OR LEGAL PROCEEDING
AND WAIVE ANY OBJECTION TO VENUE OR JURISDICTION IN CONNECTION THEREWITH.
Emergency Contact 1 : ___________________________(H)
(____) ____________ (W) (____) ___________
Emergency Contact 2
:___________________________(H) (____) ____________ (W) (____) ____________
Parent/Guardian
1
(Required if trip participant not 18 years old now)
Signature:
_________________________________________Date: _____/______/______
Print Name: ______________________________________________________________
Address:
_________________________________________________________________
Parent/Guardian
2
(Required if trip participant is not 18 years old now)
Signature:
_________________________________________Date: _____/______/______
Print Name: ______________________________________________________________
Address: _________________________________________________________________
Mail, Fax or Scan and email to:
GRADCITY.COM,
8 Essex Center Drive, Peabody, MA 01960
Fax: 978.573.2069
ATTN.: Ski Medical Release
Questions? Call 1-877-GRADCITY (472-3248)