AGREEMENT TO WAIVE and RELEASE ALL CLAIMS

I am the parent or guardian of the minor named below and have the legal capacity and authority to act on his or her behalf. I make this Agreement to Waive and Release All Claims in consideration for permission being granted to the minor to participate in the program listed below, conducted by the Pacific Grove Museum of Natural History. The Program On behalf of the minor named below and myself and my heirs, executors and assigns, I waive and release any and all claims for damages for death, personal injury, or loss of or damage to property against the Pacific Grove Museum of Natural History (the “Museum”), its officers, directors, employees, volunteers and representatives (the “Museum Representative”), which I now have or may have in the future arising out of or relating to the minor’s participation in the Program and his or her travel to, during, and from the Program. I agree not to sue the Museum or the Museum Representatives on account of any such claim, and I agree to indemnify and hold harmless the Museum and the Museum Representatives against any claim by the minor for loss of or damage to property or bodily injury or death which he or she now has or may have in the future arising out of or relating to his or her participation in the Program or travel to, during, and from the Program. I acknowledge and agree that: - I am aware of the risks of participation in the Program, such as tide pooling, hiking, walking in or near the surf zone, and other hazardous activities. - I understand that serious accidents can occur while participating in these activities which can result in bodily injury or death. - The minor will abide by all safety rules and instructions given by Museum personnel and Program leaders. - The minor’s participation in the Program is completely voluntary and at his or her own risk. I HEREBY AFFIRM THAT I AM EIGHTEEN (18) YEARS OF AGE OR OLDER AND THAT I HAVE CAREFULLY READ AND FULLY UNDERSTAND THIS AGREEMENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE PACIFIC GROVE MUSEUM OF NATURAL HISTORY, AND I SIGN IT OF MY OWN FREE WILL *

Signature

Name of Minor *

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Parent or Guardinan

Relationship to Minor *

Program

Date *

Date

YYYY

PHOTO RELEASE

I hereby irrevocably consent to and authorize the use and reproduction by the Pacific Grove Museum of Natural History, of any and all photographs which you may be taking of me in conjunction with my participation in activities that are part of the Junior Naturalist Club, including photographs, portraits, video images or electronically generated images or any accompanying information, for any purpose whatsoever, without further compensation to me. All photographs, portraits, video images or electronically generated images or any accompanying information shall constitute the Pacific Grove Museum of Natural History’s property solely and completely.

Participant Name *

Participant Initials *