When

Saturday, May 14, 2022 from 9:00 AM to 12:00 PM PDT
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Where

Pacoima Wash Natural Park 
801 Eighth Street
San Fernando, CA 91340
 

 
Driving Directions 

Contact

City of San Fernando 
(818) 898-1202 
info@sfcity.org 
 

WAIVER, RELEASE AND INDEMNIFICATION

I am an adult over the age of eighteen (18) years, and am allowing my family members listed above permission to participate in certain activities, including but not limited to activities such as, photo-taking, obstacle course races, and any other activity organized by the City of San Fernando (“activities”) and/or use of equipment provided by the City of San Fernando, including but not limited to, public parks, bounce houses, and any other equipment provided by the City as part of a City-organized event referred to as the “Event”.

I UNDERSTAND AND ACKNOWLEDGE THAT MY OR MY CHILD’S/FAMILY MEMBER’S PARTICIPATION IN CERTAIN ACTIVITIES AT THE EVENT OR USE OF CERTAIN CITY EQUIPMENT USED BY ME AT THE EVENT MAY EXPOSE ME OR MY CHILD/FAMILY MEMBER TO A RISK OF PHYSICAL HARM OR DEATH,  AS WELL AS ECONOMIC LOSS, which might result not only from my or my child’s/family member’s own actions, inactions, or negligence, but also from the actions, inaction, or negligence of others, or the condition of the facilities or equipment.  ACCORDINGLY, I ASSUME ANY AND ALL RISKS associated with my participation (and/or of my children/family member’s listed above) and/or use of the activities and/or equipment.  Specific risks might include:  a) minor injuries such as scratches, bruises, and sprains; b) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions; and c) catastrophic injuries including paralysis and death.  Additional potential risks and injuries may include: falls, improper use of equipment and/or defective equipment.  ALL SUCH RISKS ARE KNOWN AND ACKNOWLEDGED BY ME.

I agree that if I observe any facilities and equipment to be used and believe them to be unsafe, I will immediately advise the supervisory person at the facility.

I recognize that certain medical conditions and/or physical conditions known to me may pose a likely and/or foreseeable risk of injury, death or other harm should I, my child, or my family members listed above participate in any of the activities contemplated herein.  By execution of this waiver, release and indemnification, I assume full responsibility for any and all risks posed by any medical condition or physical condition suffered by me, my child or family member’s listed above whether known or unknown to me.

For myself, heirs, personal assigns, and anyone entitled to act on my behalf, do hereby forever waive, release, discharge, and covenant not to sue the City of San Fernando, its elected or appointed officials, officers, agents, employees, and other volunteers, and the owner of any private property where events or activities are held, from any and all liability, claims, damages, expenses, and judgments, including attorney’s fees, arising from participating/volunteering with the City of San Fernando. This release, waiver, and indemnification extend to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. I further agree that the City of San Fernando may take photographs of me and/or of my children for participating/volunteering at various events and activities and use such pictures at its discretion for public display or advertising purposes without any compensation to me.

For myself, my heirs, personal assigns, and anyone entitled to act on my behalf, assume any and all risks of personal injuries to myself, including medical or hospital bills, permanent or partial disability, or death and damages to my property, real or personal, caused by or arising from participating/volunteering with the City of San Fernando.

For myself, my heirs, personal assigns, and anyone entitled to act on my behalf, agree to forever indemnify and hold the City of San Fernando and its officials, employees and agents harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorneys’ fees brought as a result of myself participating with and on the City of San Fernando’s equipment and facilities, and/or volunteering with the City of San Fernando, and to reimburse them for any such expenses incurred.  I recognize that this waiver and release, assumption of risk and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, agree that the balance shall continue in full legal force and effect and if signing on behalf of an organization, I have the capacity and am duly authorized to enter into this agreement on the organizations behalf.

I, the undersigned, consent to have myself, and/or my children/family members photographed, interviewed, and/or videotaped by representatives of the City and its affiliated entities.  The City and its affiliated entities may use the images/likeness for the production of City of San Fernando marketing/promotional material.  With respect to all photos, videotaping and audio records, and any reproductions of same in any medium, including the City’s websites, I hereby irrevocably consent to and authorize their use by the City and its affiliated entities for reproduction, distribution, and exhibition for any purpose and in any medium whatsoever including (but not limited to) publication and exhibition for educational purposes, without any compensation or notice to me. 

I understand and agree that such materials, including all negatives, positives, and prints, shall become and remain the sole property of the City and I shall have no right or title to such items.  I further understand and agree that these materials may be kept on file and/or used by the City for potential future use and further agree to release the City and its affiliated entities from any and all liability arising from or in connection with taking, use, publication, or dissemination of such materials.

COVID-19 ACCEPTANCE OF RISK AND WAIVER OF LIABILITY

By my participation I am fully aware that there are a number of risks associated with me and/or my child/family entering onto City of San Fernando property, participating in City programs, and utilizing City equipment and facilities during the COVID-19 pandemic. This waiver, release, and other representations and covenants set forth herein are given in consideration for City permitting me and/or my child to participate in City programs during this emergency period.

Therefore, without limitation, I understand that I and/or my child/family could contract COVID-19 disease which could result in a serious medical condition requiring medical treatment in a hospital or could possibly lead to death.

On behalf of myself and/or my child/family and our heirs, successors, and assigns, I knowingly and freely, assume all such COVID-19 related risks, both known and unknown, relating to my and/or my child’s/family’s entry onto City property, participation in City programs, and utilization of City equipment and facilities as described above, and I hereby forever release, waive, relinquish, and discharge City, along with its officers, agents, employees, or other representatives, and their successors and assigns (collectively, the “City Representatives”), from any and all COVID-19 related claims, demands, liabilities, rights, damages, expenses, and causes of action of whatever kind of nature, and other losses of any kind, whether known or unknown, foreseen or unforeseen, (collectively, “Damages”) as a result of me and/or my child/family entering onto City property, participating in City programs, and utilizing City equipment and facilities as described above, including but not limited to personal injuries, death, disease or property losses, or any other loss, and including but not limited to claims based on the alleged negligence of any City Representative or any other person related to COVID-19 sanitization. I further promise not to sue City or any City Representative, and agree to indemnify and hold them harmless from any and all Damages resulting from me and/or my child’s/family’s contraction of COVID-19.

THIS DOCUMENT RELIEVES THE CITY AND OTHERS FROM LIABILITY FROM PERSONAL INJURY, WRONGFUL DEATH, AND PROPERTY DAMAGE CAUSED BY NEGLIGENCE.  I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, AND I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, INCLUDING THE RIGHT TO SUE, AND I SIGN VOLUNTARILY.