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I as the Parent/Legal Guardian of my child, hereinafter referred to as the Perspective Team Member or Student or Participant, permit my child to participate in Danbury (LEGO) Robotics/Danbury Robotics and its teams in the 2018-19 Season Program(s) AND

RELEASE, HOLD HARMLESS AKOMA FOUNDATION, INC., d/b/a Danbury LEGO Robotics, Danbury Robotics and any and all programs run and affiliated by AKOMA Foundation, Inc.,. et. al, including but not limited participation in all FIRST programs and programs outside of FIRST that are supported and run by AKOMA Foundation, Inc. and its' affiliates.

This is a Consent and Release of Rights in favor of AKOMA FOUNDATION, INC. (AFI) D/B/A Danbury LEGO Robotics (DLR) and Danbury Robotics (DR) and its officers, coaches, advisors, mentors, team parents, volunteers, employees and assigns as well as entities designated and approved to assist AFI and/or DLR and/or DR in managing, contracting, sponsoring, hosting, conducting, evaluating or publicizing. As used below, "Participant" shall mean any individual, student, parents or others involved in an AFI and/or DLR and/or DR "Events" defined as, including but not limited to summer programs, team meetings, team activities, field trips, tournaments, events, exhibitions, etc.,.

In consideration of the acceptance of my child/student and me/ parent/guardian participation in AFI and/or DLR and/or DR and its teams, I agree to the following: There are risks inherent in participating in Events, any team and/or AFI and/or DLR and/or DR activities including the risks inherent in the construction of robots and LEGO structures, as well as in working with electrical power, mechanical parts, machine and power tools, traveling to and from events and participating in public competitions, etc.,. These risks include the risk of bodily harm, including without limitation, death and property damage. I understand and agree that AFI, DLR and DR cannot be expected to control all of said risks. Being fully cognizant of the risks in participating as described herein and unanticipated risks,

I hereby expressly, knowingly and voluntarily assume those risks and WAIVE ANY AND ALL CLAIMS OR CAUSES OF ACTION which I may now or hereafter have against, AFI, and/or DLR and/or DR and its officers coaches, advisors, mentors, etc.,., arising out of my participation in any team or club meetings, events, activities, etc.,. and I voluntarily and knowingly agree to hold harmless, protect and indemnify AFI, DLR and DR their officers, agents, volunteers, employees, etc.,. from any and all claims and demands, causes of actions, including but not limited to property damage, personal injury, and even death, resulting from such participation, whether caused by my own negligence or the negligence of AFI and/or DLR and/or DR and/or their officers, agents, coaches, volunteers, employees, etc.,.I hereby Expressly, Knowingly and Voluntarily Release AFI, DLR and DR and their respective, officers, coaches, mentors, agents, volunteers, employees, successors, affiliates, licensees and assignees, etc.,. from any and all claims, demands, liabilities, damages, costs and expenses, causes of action, including but not limited to attorney's fees, other professional fees, medical expenses and any claims including without limitations, claims for compensation, defamation, invasion of privacy or other infringements or violations of personal property rights, property damage or any sort whatsoever even if by my own negligence or the negligence of an officer, coach or volunteer, etc.,. that I may now or hereafter have against AFI, DLR, and DR arising in connection with my participation in any activities.

If any such action is brought against AFI and/or DLR and/or DR, in connection with my participation, I shall be notified in writing. Upon such notification, I or my representative will promptly take over and defend such claim or action. I shall be responsible for any and all resulting fees, including but not limited to attorneys fees, medical fees and any and all other fees, expenses, judgements, etc.,. in the defense of such action.

Medical Release

In the event I or my child should sustain injuries or illness, while involved in an Event, I hereby authorize team coaches and/or team mentors/parents to administer or cause to be administered, such first aid or other treatment and medications I may bring or as may be or they may deem necessary under the circumstances, including but not limited to treatment by a physician and/or a hospital. I agree to hold them harmless if I disagree with the decision they have made and I agree that any and all cost of such treatment will be my sole responsibility.

Photo Release

AFI and/or DLR and/or DR may take or authorize a third party to take photographs, videos or other media recordings of events and activities associated with our programs. From time to time AFI and/or DLR and/or DR may use these media recordings on their web pages, in new articles, promotional materials, public relations materials and other legitimate non-commercial purposes. By virtue of their attendance at AFI and/or DLR and/or DR events, all attendees agree to the use of their likeness in such materials.

Connecticut Law Controls

This release shall be binding upon my heirs, personal representatives and assigns and me and shall be governed by and construed under the laws of the State of Connecticut, which shall be the venue for any and all legal actions. This Release constitutes the entire agreement among the parties hereto with respect to the subject matter of this Release and supersedes any and all previous agreements among the parties, whether written or oral with respect to such subject matter.


If any provision of this Agreement is held to be illegal, invalid or unenforceable, (a) the legality, validity and enforceability of the remaining provisions of this Agreement shall not be affected or impaired thereby and (b) the parties shall endeavor in good faith negotiations to replace the illegal, invalid or unenforceable provisions with valid provisions as close as possible to that of the illegal, invalid or unenforceable provisions.

I have read and understood this document and my signature via checking the “yes” box below evidences my intent to be bound by its terms.

I understand that this form involves a release of legal rights AND I hereby consent and agree to all of the above for myself, whether I am participating or not and including but not limited to if I act in the capacity of an assistant coach, mentor, volunteer, etc.,. AND I hereby consent and agree to all of the above as the Parent/Legal Guardian of Perspective Team member/Student/Participant listed below.

Name of Team Member *
Your answer
Name of Parents or Guardians *
Your answer
I understand, agree and consent to all the terms in this consent and release agreement. *
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