Hold Harmless Agreement: The UNDERSIGNED PARTICIPANT and/or his/her guardian, in consideration of the
Township of West Hanover, through their Parks & Recreation Board, providing facilities, instruction, and supervision in
the activity for which he/she has registered does hereby:
1. Requests permission to participate in the activity with full understanding and knowledge that by participating in
this activity, the risk of injury exists.
2. I/we state that there are no health-related reasons or problems which preclude or restrict me from participating in said activity.
3. Assume all risks and responsibilities of possible damage or injury through participation in said activity. I
understand I am to furnish my own insurance in case of injury.
4. In the event I/we need medical care from West Hanover Township, the parent/guardian is asked to sign the
consent form below. In case of a serious medical condition, West Hanover Township will make every effort to
notify the parent/guardian, but the first priority is providing care to the participant.
5. Agree to indemnify and hold harmless the Township and their departments and agents against liability for
personal injury or property damage resulting from my participation in said activity.
6. I acknowledge that programs held through the Township of West Hanover may be filled or may be cancelled due
to lack of participation.
7. Agree that once the program deadline date has past, there will be No refunds. If cancelled prior to the deadline,
you will receive a refund, minus a $10 administration fee.
8. If a check is written and returned for insufficient funds, a $25 service fee will be charged.
9. I agree to allow West Hanover Township to use any photos taken at the activity for future Township publications.