I, the undersigned, am a participant in programming of CLOVER CLUBHOUSE, LLC. (CCH), do hereby consent to my participation, or the participation of my minor child, in the programs or events (“Activities”) held at the CLOVER CLUBHOUSE located at 368 West Broadway, South Boston, Massachusetts 02127. 

 

In consideration of my participation in such CCH Activities, I on behalf of myself/my heirs, my agents and my representatives, or on behalf of my minor child, agree to forever release, acquit, and discharge, CLOVER CLUBHOUSE LLC, and all of its employees, commissions, committees, agents, board members, volunteers and any and all individuals and organizations assisting or participating in the Activities of CLOVER CLUBHOUSE LLC (“the Releasees”) from any and all actions, claims, demands, charges, rights of action, lawsuits, loss of service, compensation, costs, including without limitation attorney’s fees, and causes of action that may have arisen in the past, or may arise in the future, directly or indirectly, from my participation in the Activities, including but not limited to all known and unknown personal injuries, or property damage, which I may now have or hereafter have, or any minor child may or hereafter have, as well as any claims, demands, causes of action, charges, lawsuits, loss of services, compensation, costs, including without limitation attorney’s fees, damages and/or liability of any kind, which I have or hereafter may acquire, or my minor child may acquire, in any way arising out of or resulting from, directly or indirectly from my  participation in CCH’s Activities. 

 

I, on behalf of myself/my heirs, my agents and my representatives, and/or on behalf of my minor child, also promise to indemnify, defend, and hold harmless the Releasees from any and all claims, charges, rights of action, lawsuits, loss of service, compensation, costs, including without limitation attorney’s fees, and causes of action that may have arisen in the past, or may arise in the future, directly or indirectly, from all known or unknown personal injuries or property damage, in any way arising out of or resulting from, directly or indirectly from my participation in CCH’s Activities.

 

I have determined the nature and extent of the planned Activities and feel that I or my minor child are of sufficient ability to participate. 

 

I understand that there may be a risk of injury to me inherent in the Activities and I hereby assume these risks. I also understand that although serious injuries are not common, it is impossible to eliminate the risk. Participants have the responsibility to help reduce the chance of injury.

 

Furthermore, I authorize the CCH Staff, Doctors, and EMTs to act for me in accordance with their best judgment in an emergency situation requiring medical attention.  I also give permission to CCH Staff to transport me or my minor child to a medical facility if necessa 

 

I affirm that I have carefully read and understood this Consent and Release Form and its contents.  I understand that my participation and/or my minor child’s participation in these Activities is voluntary and that I am free to choose not to participate in said Activities. 

 

By signing this Form, I affirm that I have decided to participate in CCH’s Activities, with full knowledge that Releasees will not be liable to anyone for personal injuries and property damage I may suffer through participation in the Activities.