Teen Guys Group Registration
Teen Guys Group - Night Riders Registration
Spring Session begins Friday April 13 and runs through until Friday June 22 with the exception of Friday May 18
Location: Autism Ontario Halton Chapter Office - 4361 Harvester Rd. Unit 9, Burlington
Cost: FREE for the 10 weeks, it will funded by the Autism Ontario Potential Programme
Adult and Child/Ward Waiver/Release of Liability
*In consideration of the furtherance of your purposes, objectives and work, and in consideration of your permitting me and/or my child/ward to participate in this program or part of this program for Autism Ontario, I hereby agree that participation in the program or part of the program is and shall be at my own and my child(ren)’s/ward’s own risk against all injuries and/or damage to myself and/or my child(ren)/ward and/or my and/or my child(ren)’s/ward’s property and I myself, my assigns, my heirs, my
beneficiaries, representatives, next of kin, spouse or legal equivalent to spouse, children,wards, successors and executors hereby release, forever discharge and save and/or hold harmless Autism Ontario and its Chapters, officers, directors, officials, agents,employees, advertisers, sanctioning bodies, sponsoring companies, participants, entrants,volunteers and organizers connected with this program or part of this program from and
against any and all actions, claims, costs and expenses in respect to death, injury, loss or damage to my and/or my child(ren)’s/ward’s person or my and/or my child’s/ward’s property however caused, arising out of me and/or my child(ren)/ward(s) being permitted to participate in this program or part of this program for Autism Ontario - Halton Chapter.
*I the undersigned acknowledge that the risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and I knowingly and freely assume all risks, both known and
unknown, even if rising from the negligence of the releasees or others, and assume full responsibility for my participation.
*I do hereby voluntarily waive, grant and release the right to publish name,
article and/or photo of myself or my child to Autism Ontario. I understand that it may be:
printed in materials such as the Autism Matters magazine, annual reports,
placed on the Autism Ontario website(s), or
incorporated into promotional material such as brochures and videos.
I hereby waive any claim against Autism Ontario and staff, for any personal or emotional damage which may arise in
connection with the use of the material(s).