ACKNOWLEDGEMENT OF RISK AND ASSUMPTION OF PERSONAL RESPONSIBILITY

Inside Out (828)697-5295

I understand that participation in an Inside Out program will involve risk. I also understand that, although Inside Out has taken precautions to provide a safe environment, have proper equipment and qualified staff, it is impossible to guarantee absolute safety. I have freely chosen to participate and I hereby assume the risks associated with Inside Out’s program.

I agree to follow the instructions and directions given to me by Inside Out staff members. I understand, too, that I have a responsibility for my own safe participation in this program, and I assume this responsibility.

Parent(s)/Guardian(s)

I (we) understand the content of the Inside Out program and consent to the participation of the above named participant. Except in instances of gross neglect, I (we) release the institution known as Inside Out, Inc., and all associated staff and employees, from any liability which may arise out of, or in connection with, my (our) son/daughter/ward’s participation in an Inside Out program. I (we) grant Inside Out Inc. permission to use photographs and/or video that include the above named participant for advertising or on the Inside Out web site.