WAIVER AND RELEASE PS111 2025

This form is to allow my child of child), to participate in Spanish language instruction provided by CENY CENTRO EDUCATIVO, INC. I understand this activity or event will involve the following: Saturday & weekday Spanish language classes, including play, gymnastics and dance, which carry risks of physical injuries. Certification of Capability to Participate and Understanding of Risks/Assumption of Risks. My signature on this form is my certification that my child is physically capable of engaging in the activity or event described above, and I hereby give my consent for my child to engage in this activity or event. Further, I acknowledge that I have had the risks posed to my child by engaging in this activity or event sufficiently explained to me, and I understand these risks (or I have declined such explanation because I already understand the risks involved in the activity or event). In exchange for allowing my child to participate in this activity or event, I hereby assume all risks of injury or damages of whatever type or form associated with my child’s participation in this activity or event. I do hereby release, for injuries now or in the future, CENY Centro Educativo Inc. and PS 84 and NYC Public Schools (the “Sponsors”) and their employees, directors, officers, member, agents or other representatives, on behalf of ourselves, heirs, administrators and assigns, from any and all manner of action, causes of action, suits, debts, accounts, controversies, claims and demands whatsoever, which we or our legal representatives may have or may acquire against the Sponsors, their employees, directors, officers, members, agents or other representatives by reason of loss of property, damage to same, or by reason of the death of the participants or by any personal harm that may come to the participant by reason of such participation in said program, even if it is caused in whole or part by efforts, actions, or omissions of the Sponsors. Consent to Treatment. My signature on this form also constitutes my consent for the Sponsors to consent to medical providers diagnosing and providing medical treatment to my child at my expense in the event of injury or illness requiring emergency or other medical treatment while involved in this activity or associated with the activity. My child is covered with a health insurance police. My signature on this form also constitutes my consent for the Sponsors to communicate with the pediatrician/health care provider of or child. A photocopy of this medical authorization shall serve as effectively as an original. I waive any claims or causes of action, including attorney’s fees, I might have against the Sponsors for allowing my child to participate and also against anyone who provides medical treatment to my child in reliance upon this agreement. I agree to indemnify and hold the Sponsors harmless in the event they prov