Minor Liability Waiver

Parent or Legal Guardian
Individuals under the age of 18 years old must have parental consent to visit Aurora B’s Family Campground (referred to herewithin as “the campground” located at 1118 State Route 69, Williamstown NY 13493) without their legal parent/guardian present.

As the legal parent/guardian of the child listed below, you agree that your child has your authorization to visit the campground without your supervision/oversight and fully grant permission to the responsible party listed below with temporary custody while in their care, custody and control.
You hereby agree to release and hold harmless Aurora B’s Family Campground, their owners, respective Boards of Directors, agencies, officers, employees, committees, and volunteers, from and against any and all liability, loss, damages, claims, or actions (including legal costs and attorney fees) for any and all bodily injury and/or property damage including any mental anguish and in extreme circumstances such as loss of limbs, paralyzation, and even death, to the extent permissible by law arising from or related to my child’s visitation to the campground and/or participation in any activities or events or use of all facilities.
This indemnification and hold harmless agreement shall include indemnity against all costs (including without limitation, reasonable attorney’s fees and court costs), expenses and liabilities incurred or in connection with any such claim or proceeding brought thereon and in defense thereof.
In signing this release, indemnification and hold harmless form, I acknowledge that I have read and understand fully the foregoing agreement, and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made. I hereby give permission to the responsible party/temporary guardian of my child(ren) while in their care, custody, and control and to Aurora B’s Family Campground and their representatives to call for emergency transportation and/or treatment in the event of illness or injury. I hereby accept responsibility for the payment of any emergency transportation and/or treatment and/or any damages caused to any property as a result of my child’s actions. I further certify that I am fully competent and my child is in good physical condition, and has no medical or physical conditions that would restrict my child’s participation in any program or activity or otherwise noted below. This authorization shall be valid as of the date of electronic signature and remain in place indefinitely unless written notification is provided to revoke these privileges.

Name of Child * Child’s Date of Birth * Name of Parent/Guardian Providing Consent * Legal Guardian’s Phone Number Legal Parent/Guardian’s Email * Legal Parent/Guardian’s Address * Name of Responsible Adult being granted permission of temporary guardianship of child while at the Campground * Special notes

BY SUBMITTING THIS FORM, YOU FULLY AGREE TO THE ABOVE MINOR LIABILITY WAIVER AND OUR TERMS AND CONDITIONS AND PRIVACY POLICY.

Legal Parent/Guardian Electronic Signature (Type Full Name Below) * Today’s Date *