• *the class you enrolled in is cancelled
• you are denied membership for any reason

Release and Waiver of Liability and Indemnity Agreement

I the undersigned (if participant is 18 years of age or older) or parent/guardian of the aforementioned minor participant acknowledge my consent to the following RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT: IN CONSIDERATION for being permitted to enter the premises and participate in any events and/or engage in activities that involve risk or serious injury, including permanent disability or death, which might result not only from their own actions, inactions or negligence, but action, inaction, or negligence of others, the rules of play, or the condition of the premises or of any equipment used and further, that there may be other unknown risks not reasonably foreseeable at this time, assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death, and hereby do RELEASE, WAIVE, DISCHARGE, COVENANT NOT TO SUE, AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS, AND ASSUME FULL RESPONSIBILITY FOR, AND RISK OF, BODILY INJURY, DEATH, OR PROPERTY DAMAGE even if determined due to the negligence of the James River Home School Academy (under the umbrella of the James River Home School Foundation), their principals, members, other participants, operators, officials, sponsors, advertisers, owners and lessees of the premises used to conduct the activities and events and each of them, their officers, directors and volunteers, herein referred to as “releasees,” from all liability as a result of participation in the Programs and/or being transported to or from the same, which participation, after careful consideration I hereby authorize, and which transportation I hereby authorize.

I further agree, acknowledge, and certify that he/she: has adequate insurance to cover any injury or damage that may be caused at any event; has no medical or physical conditions which would interfere with his/her participation in any event., inclusive as permitted by the law of Virginia; and that registration to participate with the James River Home School Academy, indicates that the above TERMS and CONDITIONS have been read and voluntarily agreed to.

Furthermore, in the event of any injury or emergency, if I or my alternate emergency contact cannot be notified, I authorize the individual in charge to obtain emergency medical diagnosis and treatment for my child(ren) as deemed necessary by competent medical personnel. I hereby request and authorize any physician, dentist, and staff, duly licensed as Doctors of Medicine, Doctors of Dentistry or other such licensed technicians or nurses, hospital, or healthcare providers to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment, and give emergency medical care and treatment of the above minor. I have not been given a guarantee as to the results of examination or treatment. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named player. I understand that I am fully responsible for any, and all charges incurred in the event of such treatment and waive all claims or future claims as specified above. (1 required) I certify that I agree with the above waiver.
8. How did you hear about the James River Home School Foundation and/or James River Cobblestones? Friends or family Website search Local support group FB HSLDA James River Eagles

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Payment Instructions

Click the following link to pay online with our payment processor, NEWTEK. Remember, you must include payment for all student registrations that apply to your family or they are not considered registered.
 

James River Home School Foundation (JRHSF)
P.O. Box 574
Powhatan, VA 23139

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