Participant/Volunteer Information: Participant/Volunteer Information * Required Is the participant/volunteer a minor? * Required Parental Acknowledgment for Minors * Required I understand my child must be supervised by me or another responsible adult during the event.
Name * Required
First
Last
Date of Birth * Required Email * Required Please provide the best email address for event communication.
Address * Required
ADDITIONAL Information Participant Disability * Required Is this your first time coming on a ski trip with Wayfinder Family Services * Required SKIING Experience (The answer will have no impact to your registration.) * Required Preferred Skiing/Snowboarding Style * Required Please select your preferred skiing or snowboarding style. Note: Snowboarding availability is not guaranteed and will depend on the availability of qualified snowboard instructors on the day of the event
Do you need help coordinating transportation to Ski Resort? Transportation will be offered between Wayfinder Family Services in Los Angeles and the Ski Resort location with an additional stop in San Bernardino/Riverside County.
Ethnicity * Required Please select all that apply.
COVID Information * Required While participating in events held or sponsored by Wayfinder Family Services, consistent with CDC guidelines, participants are encouraged to practice hand hygiene, “social distancing” and wear face coverings to reduce the risks of exposure to COVID-19. Because COVID-19 is known to be contagious and is spread mainly from person-to-person contact, Wayfinder Family Services has put in place preventative measures to reduce the spread of COVID-19. However, Wayfinder Family Services cannot guarantee that its participants, volunteers, partners, or others in attendance will not encounter COVID-19.
I acknowledge that my participation (or my child’s) in Wayfinder Family Services program is at my own risk.
ACTIVITY PERMISSION AND RELEASE * Required I hereby grant participant named above permission to participate in all activities offered by or through Wayfinder Family Services, with the exception of those activities indicated above. The undersigned parent, guardian, or custodian of the above named participant hereby joins in the foregoing Activity Opt-Out Form and hereby stipulates and agrees to save and hold harmless, indemnify, and forever defend Wayfinder Family Services, their directors, officers, agents, employees, and volunteers from and against any claims, actions, demands, expenses, liabilities (including reasonable attorney fees) for negligence as a result of said participant’s participation in the activities of Wayfinder Family Services and his or her use of the property, animals, and facilities. I, on behalf of said participant, further agree not to sue Wayfinder Family Services, its directors, officers, agents, employees, and volunteers as a result of any injury that said minor suffers from negligence in connection with his/her participation in the activities of Wayfinder Family Services.
I represent that said participant have no health or physical condition that will interfere with the activities stated above or cause him/her to be more susceptible to injury than the average person. If any health conditions are present, I assume the risks associated with any such health or physical condition.
I have read and agree to the ACTIVITY PERMISSION AND RELEASE
AUTHORIZATION FOR TREATMENT / CONSENT, RELEASE, AND COVENANT * Required Medical Authorization:
In the event of a medical or dental need or emergency, every effort will be made to contact the participant or parent/guardian. If the participant or parent/guardian cannot be reached, I hereby authorize Wayfinder Family Services and its staff or officers to act as my agent (or the agent of the minor) to obtain and consent to any x-ray examination, anesthetic, medical, dental, surgical diagnosis, treatment, or hospital care deemed advisable by a licensed physician or dentist, whether such care is rendered at a medical office, hospital, or other licensed facility.
Financial Responsibility:
I understand and agree that any medical, dental, or hospital expenses incurred during participation are the responsibility of the participant if an adult, or the parent/guardian if the participant is a minor. Current medical insurance is required to participate in any program or event.
Release and Covenant:
I, on behalf of myself and/or my minor child, release Wayfinder Family Services, its officers, agents, and employees from any and all liability for accidents, injuries, or illnesses occurring during or related to participation in any program or event. I further agree not to institute any legal action against Wayfinder Family Services related to participation in its programs or activities.
Acknowledgment:
This authorization applies while the participant is enrolled in Wayfinder Family Services’ programs unless revoked in writing. I understand this form provides authority in advance of any specific medical situation and is given for the participant’s safety and well-being.
I, the undersigned participant, or, if applicable, the parent/guardian of the minor participant named below, wish for the participant to take part in the programs of Wayfinder Family Services and have read and agree to the AUTHORIZATION FOR TREATMENT OF ADULT CONSENT, RELEASE, AND COVENANT
PARTICIPANT/PARENT/GUARDIAN MEDIATION AND ARBITRATION AGREEMENT: * Required This is an Agreement to mediate and arbitrate all unresolved disputes arising from the educational, recreational, special education school, and residential services between the undersigned camper and/or their legal guardian and the Wayfinder Family Services.
In the event of any unresolved dispute, claim or controversy by the camper and/or their legal guardian against Wayfinder Family Services, its directors, officers, employees or agents, the student and/or their legal guardian agrees to submit such unresolved dispute, claim or controversy, including but not limited to all claims for breach of contract and civil torts, to non-binding mediation before a neutral independent third-party mediator and, if that process does not result in full resolution of the dispute, to final and binding arbitration, including, but not limited to, claims for breach of contract and civil torts.
The arbitration shall be conducted by a single-arbitrator s elected either by mutual agreement of the camper and/or their legal guardian and the Wayfinder Family Services or, if they cannot agree, from an odd-numbered list of experienced arbitrators provided by the American Arbitration Association. Each party shall strike one arbitrator from the list alternately until one arbitrator remains.
The arbitrator shall have all powers conferred by law and a judgment may be entered on the award by a court of law having jurisdiction. The award and judgment shall be in writing and binding and final on both parties.
Each party shall have the right to conduct reasonable discovery, as determined by the arbitrator and as provided in
California Code of Civil Procedure Section 1283.5(a).
The parties agree to submit any unresolved dispute or unresolved controversy arising out of or relating to the terms of the Agreement to mediation, and if that process does not result in full resolution of the dispute to final and
binding arbitration by a single neutral arbitrator.
Wayfinder Family Services agrees to pay for 75% of the costs of the mediation and arbitration proceedings and the fees of the arbitrator. The remaining 25% of the costs and fees of the mediation and arbitration will be paid by the camper and/or t heir legal guardian. Recognizing that parties involved in any such dispute may have limited resources, the parties agree to endeavor in good faith to identify a mediator and an arbitrator whose fees and costs are reasonable and affordable in light of that fact.
This agreement shall continue during the period of service delivery and thereafter regarding any related disputes. This agreement may only be modified for the Wayfinder Family Services by a written agreement signed by the President of the Wayfinder Family Services.
The camper and/or their legal guardian understand that by signing this Agreement, he/she gives up his/her right to a civil trial and his/her right to a trial by jury.
If any of the provisions of this Agreement are found null, void, or inoperative, for any reason, the remaining provisions will remain in full force and effect.
I, the undersigned participant, or, if applicable, the parent/guardian of the minor participant named below, wish for the participant to take part in the programs of Wayfinder Family Services and have read and agree to the PARTICIPANT/PARENT/GUARDIAN MEDIATION AND ARBITRATION AGREEMENT
MEDIA RELEASE * Required Permission is hereby given to WAYFINDER FAMILY SERVICES® to use audio, video recordings, photographic and electronically created images of the camper noted in this application for public view, including publications, websites or social media sites. Usage of any images or audio is without compensation to said person or to the undersigned on his/her behalf, or individuality.
I have read and agree to the MEDIA RELEASE
Special Event Waiver * Required In consideration of the acceptance of my family’s participation in the following activity listed on this form, I, the undersigned, intending to be legally bound, do hereby for myself and my family (including heirs, executors, administrators and assigns) forever waive, release and discharge any and all rights, claims and actions for damages that we may have, or that may hereafter accrue to us against WAYFINDER FAMILY SERVICES, including all of its officers, directors, members and volunteers.
I attest and verify that we are physically able to participate in this activity. We further understand that accidents and injuries can arise out of the event; knowing the risks, nevertheless, I hereby agree to ASSUME ALL RISKS OF PERSONAL INJURY, PERMANENT, TEMPORARY, TOTAL OR PARTIAL DISABILITLY, DISFIGUREMENT, PARALYSIS AND ANY OTHER LOSSES OR DAMAGE TO PERSON OR PROPERTY OR DEATH, sustained while participating in, attending, preparing for or traveling to and from the above described activity, including the risk of negligence of the WAYFINDER FAMILY SERVICES, or hidden, latent or obvious defects in the facilities or equipment used.
I have read this waiver and am in agreement with its contents.
Hold Harmless * Required In consideration of the acceptance of my family’s participation in the activity listed on this form, I, on behalf of myself and my family, agree if any claim for personal injury or wrongful death is commenced against WAYFINDER FAMILY SERVICES (including its officers, directors, members and/or volunteers), we will defend indemnify and hold harmless WAYFINDER FAMILY SERVICES, from any and all claims or causes of action for personal injuries, property damage or wrongful death that hereafter accrue, arise out of, result from, or are caused directly or indirectly by my family’s participation in this activity.
I agree to the privacy policy.I have read the Hold Harmless Release and am in agreement with its contents.
Signature Confirmation * Required I agree to the privacy policy.By entering my full name below, I confirm that I have read, understood, and agree to the terms outlined in the Waiver & Release of Liability above. I understand that typing my name serves as my digital signature and legally binds me to the terms of this agreement.