Please read carefully

I understand there are risks of physical injury in participating in sports and recreational activities or programs.

I hereby release The Town of Hermon, its employees, officials and agents from any and all liability or loss or damage to personal property that, my child or I may experience in connection with activities sponsored by Hermon Recreation

I hereby consent to emergency medical procedures deemed advisable for my child in the event I cannot be reached and my child has sustained an injury. The Dept. does not provide accident or hospitalization insurance for participants of its programs. All participants are advised to have adequate personal coverage. Please consider participant's own health, experience, and tolerance for risk before participating in any program.

Town of Hermon's Recreation Department
Updated Authorization/Waiver

1. I, (parent/guardian), the parent or legal guardian of the participating child indicated below (the “Child”), hereby grant permission to the Town of Hermon to perform a health screening, including taking the temperature of, the Child for the purpose of screening the Child for illness, including but not limited to COVID-19, in order to participate in the Parks & Recreation program. This permission allows screening on a daily basis and it extends to retesting the Child later in the day when I am not present in the event that Child appears ill. I understand that readings will not be recorded.

2. Participation in this activity may involve risk of injury or death.  Furthermore, I understand that participating may involve contact with other participants and staff. While the Town of Hermon is endeavoring to prevent accidental exposure of participants to people who are infected with COVID-19 through health screenings, I acknowledge that such screenings may not be 100% effective. I am aware of these hazards and I, for myself and my Child, voluntarily assume the risks associated with participation.

In registering for participation in Town of Hermon program(s) and in consideration for being allowed to participate, I, for myself and my Child, hereby waive and release all rights and claims against the Town of Hermon, its officers, employees, agents, volunteers and supervisors from all losses, injury, illness, damages, fees and other expenses arising out of, or in connection with participation in the registered activity. 

In addition, I give my consent for the Hermon Recreation Department Director to act in my place in all respects should the need arise during the course of this activity or related travel.  This shall include but not be limited to obtaining medical care.

3. This Authorization is valid through December 31, 2021, although Paragraph 1 may be revoked at any time. I understand that if I revoke this Authorization, the Child will no longer be able to participate in the Before & After Care. Paragraph 2 is irrevocable for those dates where the Child participated in the summer camp.