HSS | Family Consent Form

Family Consent, Release, and Waiver Form

As the legal parent or guardian of each child identified below, and on my own behalf, I hereby consent to such child's and my participation in the regular weekly and other special activities ("the Event") conducted by Hindu Swayamsevak Sangh U.S.A., Inc. ("HSS").
COVID-19: As the legal parent or guardian of each child identified below, and on my own behalf, I hereby represent and warrant that I have taken reasonable precautions to protect other persons attending the Event against exposure to, or the possibility of contracting, COVID-19. In particular, I hereby represent and warrant that I and each child identified below will not attend the Event if (a) any of us has had direct contact, within the fourteen (14) days before the Event, with an individual with a confirmed case of COVID-19 or (b) any of us has any symptom, including but not limited to elevated temperature of 100 or more, cough, difficulty breathing, headache, loss of taste or smell, or muscle pain, on the day of the Event.
COVID-19: As the legal parent or guardian of each child identified below, and on my own behalf, I hereby acknowledge that such child’s and my participation in the Event will include participation in athletic activities, such as sports and yogasanas, and that participation in such athletic activities may expose such child and me to the risk of bodily injury. Accordingly, I hereby further acknowledge that I have given my consent to such child’s and my participation in the Event having assumed the risk of bodily injury to such child and to me.
As the legal parent or guardian of each child identified below, and on my own behalf, in the event that such child suffers or I suffer bodily injury while participating in the Event, I hereby authorize HSS and its officers, directors, representatives, agents, and volunteers present at the Event to authorize any emergency medical or surgical treatment deemed to be in the best interest of such child or me if I am unavailable or otherwise unable to do so. I hereby further agree to assume full responsibility for the payment of all fees and expenses incurred for any such emergency medical or surgical treatment so received by such child or me. The following insurance policy or coverage is available to cover the cost of all fees and expenses incurred for any such emergency medical or surgical treatment so received by such child or me:

Insurance Co.

Group No.

Subscriber No.

As the legal parent or guardian of each child identified below, and on my own behalf, I hereby agree to RELEASE, INDEMNIFY, AND HOLD HARMLESS HSS and its officers, directors, representatives, agents, and volunteers (“the Indemnified Parties”) from all claims for damages or injunctive relief resulting from such child’s and my participation in the Event, including any claim alleging that damages or injuries were caused by the NEGLIGENCE of any of the Indemnified Parties.
As the legal parent or guardian of each child identified below, and on my own behalf, I hereby consent to the search of my child’s and my personal belongings by HSS during the Event to ensure the safety of all Event participants.
As the legal parent or guardian of each child identified below, and on my own behalf, I hereby agree that my child and I shall comply with the policies and procedures established by HSS for participation in the Event. I hereby acknowledge that, in the event that HSS determines in its sole discretion that my child or I have failed to comply with these policies and procedures, HSS reserves the right to expel my child or me from the Event immediately without refund of any fees paid.

Guardian details

First Name:

Last Name:

Email:

Cell Phone:

Other Phone:

Address details

Street1

Street2

Country

State

City

Zip

Shakha details

Shakha

Vibhag

Sambhag

Family details

Note: This form is for 1 Adult (and as guardian) and for the children under the guardianship. Every other family who is an adult has to have a separate form signed.

First Name	Last Name	Relation

Accept terms and conditions

Legal Parent or Guardian Signature: *

(Note: Typing your name is equivalent to your handwritten signature)

Date: 11-18-2024

Hindu Swayamsevak Sangh USA (HSS)

Guardian details

Address details

Shakha details

Family details