BEACONS INC. 2024 WAIVER and RELEASE OF LIABILITY
All persons must submit a COMPLETED and SIGNED "WAIVER and RELEASE of LIABILITY" to Beacons, Inc. in order for the participant listed below to attend a Beacons, Inc. activity or program. 

IF CONSERVED: This form must be signed by the Conservator. We recommend that this form be read with the Participant even if the Participant is conserved in case the Participant has any questions.

IF NOT CONSERVED: The Participant must sign this Waiver and Release. However, we strongly recommend that this form be read with a parent, at least one member of a supported decision making team, or other family or trusted contact before signing.

This WAIVER and RELEASE of LIABILITY is entered into on the date below by and between Beacons, Inc., its Board members, administrators, instructors, staff, and volunteers (referred to collectively herein as "Beacons"), and the undersigned, or legal guardian/conservator of conserved participant, wishing to participate in activities, programs, services and opportunities (collectively referred to as "Options) provided by Beacons. These activities may include interactions with animals through Love on a Leash and/or other activities onsite or in the community. 

This form shall remain in effect for the duration of the calendar year in which it was signed unless revoked in writing by the signing party.

As additional consideration for Beacons Inc. to provide options to the participants, I, for myself and for my conserved adult child(ren) (if applicable), heirs, executors, administrators, successors and assigns, release, acquit and forever discharge Beacons, its Board members, instructors, staff, volunteers, landlord and owner of the event location, from any and all claims, actions, causes of action, demands, rights, damages, costs, loss of services, expenses and compensation whatsoever, whether known and/or unknown, foreseen or unforeseen, anticipated or unanticipated, which we may have or which may hereafter accrue on account of or in any way growing out of our use of Beacons and its facilities on this or any other date.

It is further understood and agreed that all rights under Section 1542 of the Civil Code of the State of California and any similar law of any state or territory of the United States are hereby EXPRESSLY WAIVED.  Said section reads as follows:

Cal. Civ. Code Section 1542 - Certain claims not affected by general release.
A general release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him must have materially affected creditor's settlement with the debtor.

Beacons, Inc. is an alcohol free, drug free and smoke free campus. No alcoholic beverages or drugs may be consumed while on the premises including during PathFinder or other workshops, Club Beacons or other Programs. Anyone consuming any of these items during programming (including programming held over Zoom) will be asked to leave immediately and will need to be picked up by a third party. Continuation in Beacons programs will be decided on a case by case basis. There is no smoking or vaping on Beacons property.

COVID-19 Acknowledgements 
The individual executing this document acknowledges that Beacons Inc. cannot prevent you [or your child(dren) or adult conservatee] from becoming exposed to, contracting, or spreading COVID-19 while utilizing Beacons services or premises. It is not possible to prevent the presence of the disease although Beacons will observe safety measures to reduce the presence and spread of COVID-19 at its site.

You acknowledge that you have had the opportunity to ask questions about the safety measures to be used, and to visit the site before signing this Waiver of Liability & Assumption of Risk.

If you choose to utilize Beacons services and/or enter onto the Beacons premises, you may be exposing yourself or your loved one who is conserved or a minor to and/or increasing your or your loved one’s risk of contracting or spreading COVID-19. Therefore, to use Beacons services or premises, individuals are asked to complete this Waiver of Liability and Assumption of Risk before proceeding onsite or with Beacons services.

ASSUMPTION OF RISK:
I have read and understood the above warnings and acknowledgements concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children or adult conservatee, and being around animals (especially dogs) in order to utilize Beacons services, enter Beacons premises and participate in offsite activities (including volunteer activities). These services are of such value to me [and/or to my children or adult conservatee], that I accept the risk of being exposed to, contracting, and/or spreading COVID-19, possibly injury during office or onsite activities, and possible animal-related injury (through Love on a Leash and/or activities onsite or in the community that may involve animals) in order to utilize Beacons services and premises in person.

WAIVER OF LAWSUIT/LIABILITY
I hereby forever release and waive my right to bring suit against Beacons and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Beacons services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

CHOICE OF LAW
I understand and agree that the law of the State of California will govern this contract. Any claims or disputes arising hereunder will be interpreted in accordance with California law in the appropriate venue in San Diego County.

I DECLARE THAT THIS AGREEMENT CONTAINS THE ENTIRE AGREEMENT BETWEEN THE PARTIES AND THAT THE TERMS ARE CONTRACTUAL AND NOT MERELY RECITALS. I AM OF LEGAL AGE AND CAPACITY AND WILLINGLY ENTER INTO THIS AGREEMENT AND AGREE TO BE BOUND BY THEM.

IF ANY PROVISION IS FOUND TO BE INVALID OR UNENFORCEABLE, the remainder will remain valid and enforceable.  Any disputes hereunder will be interpreted in accordance with California law with venue in San Diego County.

Copyright © 2021 - 2025, Beacons Inc.

Sign in to Google to save your progress. Learn more
Email *
Participant's name: *
Is the intended participant conserved? *
Name of person completing Waiver and Release of Liability who has decision making ability. (If conserved: the conservator's name should be listed here. If NOT conserved: the Participant's name should be listed here). *
If the participant is not conserved, does person have a supported decision making team *
If a participant has a supported decision making team, please list at least one of the people on the team and the person's email: *
Cell Phone Number of person completing this form: *
Emergency Contact # *
Participant’s Cell Phone Number: *
Checking for understanding
I understand and agree to the terms of this WAIVER and RELEASE OF LIABILITY.
*
Form Assistance
Did anyone help you complete this form? If yes, please list who helped you with this form. Thank you!
*
ELECTRONIC SIGNATURES • Please Read!
Electronic signatures have the same legal status as handwritten signatures under the Electronic Signatures in Global and National Commerce Act (ESIGN). By signing this questionnaire/form, you attest, under penalty of perjury, that the information is true and correct to the best of your knowledge. If you wish to opt out of signing this questionnaire electronically, please print out the signature page and sign it and bring the printed document to Beacons and give to the instructor or person responsible for the activity/ies.
SIGNATURE of PERSON WITH DECISION MAKING AUTHORITY (if conserved, the Conservator should sign): *
Today's Date: *
MM
/
DD
/
YYYY
BEACONS REVIEWER: Please check the form and make sure the form is signed by the proper party, and complete. If form is complete and properly signed, please add your initials below. Thank you!
INITIALS of Beacons Reviewer: ______________________________________________________
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Beacons, Inc..

Does this form look suspicious? Report