RELEASE AND EMERGENCY MEDICAL AUTHORIZATION
The undersigned, for themselves and/or their children as hereinafter named, hereby releases and discharges the Town of Cornwall, its officers, commissioners, commissions, employees, and agents from any and all liability for any loss or damage to property of or bodily injury or death to the undersigned arising from or related to the undersigned’s participation in the town-sponsored activity hereinafter specified; and
The undersigned does hereby further knowingly, intentionally, freely and expressly:
- assume the risk for any loss, damage, bodily injury or death arising from, related to, or occurring during the undersigned’s participation in the town-sponsored activity hereinafter specified; and
- releases the Town of Cornwall and its officers, commissioners, commissions, employees and agents from any and all liability for any such loss, damage, bodily injury or death to the undersigned; and
- waives any claim or cause of action which the undersigned may have against said Town or its officers, commissioners, commissions, employees and agents for any such loss, damage, bodily injury or death.
If the undersigned cannot be reached, the undersigned does hereby give permission to the physician selected by the Recreation Department of the Town of Cornwall or program supervisor to hospitalize, secure proper medical treatment for, and/or to order injection, anesthesia, or surgery for myself and/or my child as participants in the town-sponsored activity hereinafter set forth.