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Indian River County Parks and Recreation <br />ADOPT -A -PARK PROGRAM <br />MINOR PARTICIPANTS <br />I, the undersigned, hereby represent that my child(ren) has/have volunteered to participate in the <br />Adopt -A -Park Program during the Agreement period <br />I have read the safety recommendations associated with the Program and have discussed them with <br />my child(ren). <br />I acknowledge and am aware that participation in this program has inherent risks and hazards. I <br />understand that it is my child(ren)'s responsibility to be aware of his/her physical condition and <br />refrain from doing any physical activities beyond his/her capabilities. <br />I agree to defend, indemnify and hold harmless Indian River County, and it officers and its employees, <br />and hereby release the same, from and against any and all liability, claims, demands and expenses, <br />including court costs and reasonable attorney fees, on account of any property damage, bodily <br />injury, sickness, damage, or other loss of any kind whatsoever, which arise out of or are in any <br />manner connected with the work to be performed under the Adopt -A -Park Program, if such injury, <br />loss or damage is caused in whole or in part by, the act, omission, or other fault of my child(ren). <br />Name of Child: <br />Address: <br />Name of Child: <br />Address: <br />Name of Child: <br />Address: <br />Contact in Case of Emergency: <br />Emergency Contact Telephone Number(s): <br />Parent's Signature: <br />Date: <br />01/18/2023 <br />228 <br />