Serving Children from the Monmouth County community on the generously donated campuses of The Rumson Country Day School and Christian Brothers Academy.

2021 Horizons Staff Release Form


I, the parent or guardian of ____________________ (“Participant”), have requested that Participant be permitted to attend or participate in Horizons (“Activity”) on or from June 22, 2021 to July 30, 2021 and to use property, equipment and facilities of Rumson Country Day School (“Rumson”), Christian Brothers Academy (“CBA”), and Horizons (collectively “Property”). I represent that Participant has no limitations that would prevent Participant from participating safely in the Activity. I understand that, while the activity will be conducted on the property under an arrangement between the sponsor of the activity and Rumson and CBA, Rumson and CBA will not supervise, sponsor, endorse, or otherwise be connected with the activity. I also understand that Participant will not be permitted to Participate in the Activity without executing this Waiver, Release and Covenant Not to Sue (hereinafter “Release”).

  1. Acknowledgement of Risk.

I understand that accidents, injuries and even death can occur during the Activity at the Property and/or through the use of the Property and that there may be risks and dangers not known to me or the Participant and that are not reasonably foreseeable at this time. I further recognize and appreciate that participating in the Activity may require me or Participant to perform activities, or to be exposed to activities, conditions, individuals, equipment or events which could cause injury, death, or property loss. These risks and dangers include, but are not limited to, exposure to and infection with COVID-19 or the novel coronavirus (“COVID-19”), which may result in significant and serious illness, including, but not limited to, bodily injury, disfigurement, temporary or permanent disability, and death. I understand that despite any safety precautions that are taken, there remains a risk that Participant or me could become infected with COVID-19 and/or become a symptomatic or asymptomatic carrier of COVID-19. These risks and dangers may be caused by the negligence of the Participant, of other Participants and/or of the Rumson, CBA, and Horizons Releasees (as defined below), or others.

  1. Assumption of Risk / Representation.

I, on behalf of myself, and on behalf of the Participant as his or her parent or guardian, and our executors, administrators, heirs, successors, assigns, and next of kin, HEREBY FULLY ASSUME THE RISKS OF INJURY, ILLNESS (INCLUDING BUT NOT LIMITED TO EXPOSURE TO AND INFECTION WITH COVID-19), DISABILITY, DEATH, LOSS OR DAMAGE TO PERSON OR PROPERTY INHERENT IN, ARISING FROM AND/OR IN ANY WAY CONNECTED WITH, ATTENDING, PARTICIPATING IN, VOLUNTEERING AT, AND SPECTATING AT THE ACTIVITY AT THE PROPERTY EVEN IF ARISING FROM THE NEGLIGENCE OF OTHER PERSONS. I understand that Rumson, CBA, and Horizons are not obligated to and may not have insurance to cover any claims, costs or liabilities arising from the Activity.

  1. Release, Indemnification and Covenant Not to Sue.

I RELEASE, INDEMNIFY, HOLD HARMLESS, AND DISCHARGE, Rumson, CBA, and Horizons, their officers, trustees, employees, agents, attorneys, volunteers, students and contractors (“Rumson, CBA, and Horizons Releasees”) in connection with any claim or in any way connected with the Participant’s participation in the Activity at the Property, including, without limitation, my presence on the Property and any claim by a third party relating to Participant’s participation in the Activity. I AGREE NOT TO BRING ANY CLAIM AGAINST THE RUMSON, CBA, and HORIZONS RELEASEES which concerns in any way injury, illness (including but not limited to exposure to and infection with COVID-19), death, damage, or loss of any type or nature, which arises out of, is related to, or is in any way connected with Participating in the Activity, and/or which arises out of or is connected in any way with the Participant’s use of, or my or the Participant’s presence at, the Property at which the Activity is held. I also agree to indemnify, defend and hold harmless the Rumson, CBA, and Horizons Releasees from any claims and liabilities including, without limitation, for attorneys’ fees and costs, which may be incurred by or assessed against them as a result of, or arising out of, any threatened or actual claim, suit or proceeding relating to any matter subject to the Release or to my legal capacity or authority to act for and on behalf of the aforesaid minor in the execution of this Release. This paragraph is not intended to and does not include any claim that cannot be waived by private agreement, such as claims for gross negligence, recklessness or intentional conduct.

  1. Full and Final Release.

This Agreement is a full and final release covering all known and unknown and unanticipated injuries, death, damage or loss of any type to me or Participant that have arisen or may arise from any matter subject to this Release. I am aware that I may hereafter discover facts in addition to, or different from, those which I now know or believe to be true, but it is my intention hereby, fully and finally and forever, to settle and to release any and all matters, disputes and differences, known or unknown, suspected or unsuspected, that do now exist, have existed or may hereafter exist with respect to the matters described herein.

  1. Miscellaneous.

I expressly agree that the provisions contained in this Agreement are intended to be as broad and inclusive as permitted by the laws of the State of New Jersey and that if any portion hereof is held invalid or unenforceable, I agree that the balance shall continue in full legal force and effect. I agree that the laws of the State of New Jersey shall apply to any claims arising out of this Agreement or the Activity, and I hereby consent to the jurisdiction of the federal and state courts of New Jersey with respect to any dispute arising out any such claims.

I, the undersigned parent/legal guardian of Participant, hereby execute the foregoing Release on behalf of myself and the minor named herein. I represent that I have carefully read this Agreement in its entirety and I have satisfied myself that I understand what it means. By signing this Agreement, I affirm that I have decided to allow the Participant to Participate in the Activity with full knowledge that the Releasees will not be liable to anyone for any personal injuries, illness (including but not limited to exposure to and infection with COVID-19), or property damage Participant or I may suffer due to Participant’s Participation in the Activity. I hereby bind myself, the minor named herein, his/her executor, administrators, heirs, successors, assigns, and next of kin, to the terms of this Release. I also represent that I have the legal capacity and authority to act for, and on behalf of, such minor.

(* Denotes Required Fields)

Participant First Name: *
Participant Last Name: *
Participant Role: *
Please provide your electronic signature below executing this Waiver, Release and Covenant Not to Sue. 
Participant Electronic Signature: *