BGCM Day Camp!
May 1, 2023
7:30AM-5:30PM
Roney Clubhouse: 4501 N 34th St, McAllen, TX 78504
Brand Clubhouse: 2620 West Galveston, McAllen, TX 78501
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Child's Name/ Nombre del Nino *
Child's Grade Level /Grado del Nino  *
Child's School / Escuela del Nino *
Parent's Name/ Nombre del padres *
Primary Phone Number/Numero del Contacto *
Secondary Phone Number/Numero del Contacto Secondario *
Home Address/ Direccion de Residencia *
Allergies/ alergia *
Additional Information about your child/ información adicional sobre su niño *

WAIVER OF LIABILITY & RELEASE AND HOLD HARMLESS AGREEMENT


FOR AND IN CONSIDERATION OF BEING PROVIDED SERVICES TO MY CHILD(REN) BY

THE BOYS & GIRLS CLUB OF MCALLEN AND AFFILIATES, I, FOR MYSELF, MY HEIRS, NEXT OF KIN, PERSONAL REPRESENTATIVES, SUCCESSORS, AND ASSIGNS, HEREBY RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS, AND COVENANT NOT TO SUE THE BOYS & GIRLS CLUB OF MCALLEN ITS OFFICERS, ELECTED OFFICIALS, BOARD OF DIRECTORS, EMPLOYEES, AGENTS, CONTRACTORS, AFFILIATES, ITS SUCCESSORS AND ASSIGNS FROM ALL LIABILITY, DAMAGES, CLAIMS, DEMANDS, PERSONAL INJURY, CAUSES OF ACTION, COURT COSTS, ATTORNEYS’ FEES AND OTHER EXPENSES ARISING FROM ANY LAWSUIT THAT MAY OTHERWISE ACCRUE FROM ANY LOSS, DEMAND, CLAIMS, DAMAGES, PERSONAL INJURY, INCLUDING DEATH, TO MY PERSON, MY CHILD(REN), OR PROPERTY IN ANY WAY CAUSED OR ALLEGED TO BE CAUSED, IN WHOLE OR IN PART, RELATED TO AND IN CONNECTION WITH THE SERVICES PROVIDED.

In checking "yes", I understand and acknowledge that I have read and understand this Agreement; that by checking "yes" voluntarily and for full and adequate consideration, fully intending to be bound by the same; and that I am at least eighteen (18) years of age and am the parent or legal guardian of the child mentioned above. 

I HAVE READ THIS WAIVER OF LIABILITY & RELEASE AND HOLD HARMLMESS

AGREEMENT AND ACKNOWLEDGE THAT I UNDERSTAND ALL THE ABOVE STATEMENTS AND VOLUNTARILY CONSENT TO THIS AGREEMENT.


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