RELEASE OF LIABILITY
In exchange for participation in the activity of attending the Leaders 4 Social Civics workshop hosted at Lesley University at 29 Everett St, Cambridge, MA organized by ACADEMY 4 SOCIAL CIVICS INC, of 1 Beacon St, Fl 15, Boston, MA 02108 and/or use of the property, facilities and services of ACADEMY 4 SOCIAL CIVICS INC, I agree for myself and my child/children to the following:
1. AGREEMENT TO FOLLOW DIRECTIONS. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by ACADEMY 4 SOCIAL CIVICS INC, or the employees, representatives or agents of ACADEMY 4 SOCIAL CIVICS INC.
2. ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge ACADEMY 4 SOCIAL CIVICS INC for injury, loss or damage arising out of my or my family’s use of or presence upon the facilities of ACADEMY 4 SOCIAL CIVICS INC or LESLEY UNIVERSITY, whether caused by the fault of myself, my family, ACADEMY 4 SOCIAL CIVICS INC or other third parties.
3. INDEMNIFICATION. I agree to indemnify and defend ACADEMY 4 SOCIAL CIVICS INC against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family’s use of or presence upon the facilities of ACADEMY 4 SOCIAL CIVICS INC.
4. FEES. I agree to pay for all damages to the facilities of ACADEMY 4 SOCIAL CIVICS INC or LESLEY UNIVERSITY caused by any negligent, reckless, or willful actions by me or my family.
5. CONSENT. I, (Parent/Gaurdian) consent to the participation of my child/children, in the activity of attending an academic workshop, and agree on behalf of the above minor to all of the terms and conditions of this Agreement. By signing this Release of Liability, I represent that I have legal authority over and custody of my child/children.
6. MEDICAL AUTHORIZATION. In the event of an injury to the above minor during the above described activities, I give my permission to ACADEMY 4 SOCIAL CIVICS INC or to the employees, representatives or agents of ACADEMY 4 SOCIAL CIVICS INC to arrange for all necessary medical treatment for which I shall be financially responsible. This temporary authority will begin on July 06, 2026 and will remain in effect until terminated in writing by the undersigned or July 24, 2026, whichever occurs first. ACADEMY 4 SOCIAL CIVICS INC shall have the following powers:
a. The power to seek appropriate medical treatment or attention on behalf of my child as may be required by the circumstances, including without limitation, that of a licensed medical physician and/or a hospital;
b. The power to authorize medical treatment or medical procedures in an emergency situation; and
c. The power to make appropriate decisions regarding clothing, bodily nourishment and shelter.
7. APPLICABLE LAW. Any legal or equitable claim that may arise from participation in the above shall be resolved under New York law.
8. NO DURESS. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if I so desire. I further agree and acknowledge that ACADEMY 4 SOCIAL CIVICS INC has offered to refund any fees I have paid to use its facilities if I choose not to sign this Agreement.
9. ENFORCEABILITY. The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.