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California State University, Long Beach
Summer Camps at The Beach
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General Release and Waiver of Liability and Hold Harmless Agreement

You must print, complete and sign a General Release and Waiver of Liability and Hold Harmless Agreement for each child. A separate application and waiver is required for 49er Youth Fitness Camp.

Print Academic Enrichment Camp Waiver

Please Read Carefully. This is a Release of Legal Rights.

In consideration of being allowed to participate in any way in the Academic Enrichment Camp 2012 (Program) and/or being permitted to enter for any purpose any restricted area (defined as any area where admittance to the general public is prohibited). I, the parents(s) and/or legal guardians(s) of the named minor participant agree to assume all risk of any kind for injury or damage the minor participant may receive, sustain or cause as a result of participation, including property loss, property damage, personal injury or death.

By my signature below, I acknowledge my understanding of this release and hold harmless and agree and confirm that:

  1. As the parent/guardian, it is my responsibility to instruct the named minor participant if he or she believes anything is unsafe, he or she sould immediately dvise the officals of such a condition and refuse to participate.
  2. The above named minor participant may, during the course of the Program, participate in the following activities:
    1. arts and crafts;
    2. health related fitness;
    3. various academics;
    4. computers
  3. I grant permission for the named minor participant to receive medical treatment for any and all injuries and illnesses sustained or experienced during his/her participation in the Program Camp activities, included but not limited to emergency first aid, emergency transport to a medical facility, and emergency treatment by medical personnel onsite or at a medical facility; and, I understand, agree and assume all responsibility, including financial, for all such medicall-related actions.
  4. I KNOWINGLY AND FREELY ASSUME ALL RISKS, BOTH KNOWN AND UNKNOWN, AND HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS, FOR MYSELF, THE NAMED MINOR PARTICIPANT AND OUR HEIRS, ASSIGNS AND NEXT OF KIN, THE STATE OF CALIFORNIA; THE TRUSTEES OF THE CALIFORNIA STATE UNIVERSITY, CALIFORNIA STATE UNIVERISTY, LONG BEACH, AND CALIFORNIA STATE UNIVERSITY, LONG BEACH FOUNDATION, ASSOCIATED STUDENTS INC., 49ER SHOPS, AND EACH OF THEIR TRUSTEES, OFFICERS, EMPLOYEES AND VOLUNTEERS (RELEASES) WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with the presence or participation of the minor in my charge, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
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