The undersigned(s) being the lawful parent(s) and/or guardian(s) (collectively “Parent”) of the above-named Child, hereby consent to the participation by the Child in the educational activities, curriculum, and programs (the “Program”) conducted by Eclipse Learning Corp. (a Code Ninjas Franchisee) and its directors, officers, employees, agents and authorized personnel (collectively, the “Provider”), and to the participation of the Child in all events and activities related to said Program. This document is referenced herein as both “Release” and “Agreement” and Parent enters into it voluntarily after reading the information below.
I. Services Provided. In exchange for Parent’s payment(s), assumptions of risk, releases of liability, and/or waivers of liability described herein, Provider agrees to provide its Program(s) to Child in accordance with the dates and times available under Provider’s published information, which may be subject to change at Provider’s discretion.
Each student agrees to and shall abide by the Program(s) rules of conduct and to be courteous and respectful of other students and instructors. Provider reserves the right, in its sole discretion, to dismiss , refuse or discontinue services if a Child or Parent: (a) Engages in conduct that Provider deems to be a violation of the Program and/or the Center rules of conduct, as amended from time-to-time; (b) Exhibits behavior that is disruptive, uncooperative, defiant, or dismissive of instruction given by any person in authority; (c) Uses harsh, offensive or threatening language or engages in threatening behavior: and or, (d) Poses a threat to self, staff or other students. Provider has an anti-bullying and zero tolerance policy. Parent and Child understands that bullying will not be tolerated (whether it be cyberbullying, physical or verbal acts, or any activity that disrupts the learning environment), that Provider may take corrective action to prevent and stop any such activity, and that a violation of the anti-bullying rule is a basis for immediate dismissal from the Program. Child agrees to notify Provider immediately if he/she becomes aware of any harmful activity.
Parent acknowledges that class space is limited, and that Provider will suffer harm if my Child is dismissed from the Program for any reason above, or for other reasonable cause. Such dismissal shall not relieve Parent of any duties or payment obligations thereafter or entitle Parent to any refund. Furthermore, although the Program requires active participation of Child in accordance with the Program’s curriculum: Provider does not warrant any specified success rate or result with respect to Child’s participation in the program. Understand that this program teaches specific skills, but my child may or may not acquire or attain a certain skill level or proficiency during the program.
Payment & Emergency Acknowledgement
PROGRAM IS NOT LICENSED WITH THE STATE OF UTAH AND IS NOT CONSIDERED A SCHOOL, CHILD CARE FACILITY, DAY CARE FACILITY OR AFTER-SCHOOL PROGRAM. AS SUCH, PROVIDER IS NOT REQUIRED TO COMPLY WITH STATE LICENSING STANDARDS, MONITORING REQUIREMENTS NOR STATE IMPOSED REGULATIONS. PARENT ACKNOWLEDGES THAT THE CURRICULUM PROVIDED DOES NOT, AND WILL NOT, QUALIFY PROVIDER TO SERVE AS A CHILD CARE FACILITY, DAY CARE FACILITY OR AFTER-SCHOOL PROGRAM NOW OR IN THE FUTURE.
II. Payment for Services. Payment for following Program(s) shall be payable at time of registration.
III. Emergency Medical Treatment. In the event of a medical emergency, the Program staff will first use reasonable efforts to contact Child’s parent(s) and/or guardian(s) before administering or authorizing any treatment. However, Parent understands that Provider does not have medical personnel available at the Facility. Parent agrees and hereby grants Provider permission to authorize necessary emergency medical treatment, to Child. Parent further unconditionally agrees to release, indemnify and hold harmless Provider for such authorization in accordance with section VII of this Agreement, and understands and agrees that Provider bears no responsibility for any injury or damage which might arise out of or in connection with such authorized emergency medical treatment. Parent further states that there are no undisclosed mental, emotional, or physical health-related conditions which preclude or restrict Child from use of the Program, and that Child has adequate health insurance to provide for and pay any medical costs that may be attendant as a result of injury which occurs to Child while involved in the Program. Parent further acknowledges that it is Parent’s sole responsibility to fully inform and update Provider of any condition of Child, including but not limited to drug and food allergies, dietary restrictions, and other conditions; however, Parent agrees that Provider is not required to take any action or bear any responsibility for any injury to any person which arises from such condition.
Please list any and all allergies.
Authorize Emergency or Medical Treatment
I authorize emergency or urgent medical treatment as needed for my Child. It is understood that this authorization is given in advance of any specific diagnosis or treatment and I hereby waive and forever release all claims against and hold Provider and its staff harmless from any liability for any injuries or harm to Child while participating in the Program.
Assumption of Risk
IV. Acknowledgement, Acceptance and Assumption of Risks. This document provides and imparts sufficient warning that dangerous conditions, risks and hazards risks inherent in utilizing the Program and in any independent activities undertaken related thereto. I understand that Child’s presence and participation in the Program may expose them to such dangerous conditions, risks and hazards, which include, but are not limited to, theft or destruction of personal property, exposure to internet content, other children, personal injury to Child or other family member at the Facility, and Parent voluntarily signs this Release on behalf of myself and Child in favor of Provider, in consideration for the opportunity to have Child participate in the in the Program(s) and engage in other activities sponsored by Provider, including but not limited to: interactions with staff and other students, interaction with computer technology and the internet, consumption of food, and any indoor or outdoor activities related to curriculum or Program(s). I hereby attest and verify I have been sufficiently warned of the potential risks, and I have full knowledge of the risks of my Child’s involvement in these activities. I assume any expenses incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses. As further consideration for Child’s participation in the Program, I also agree to assume all risks inherent in my Child’s noncompliance with the laws of the State of Utah, as well as any code of conduct applicable to the Program students in general. Parent understands and agrees that Child will be expected to abide by these rules and to exhibit appropriate behavior at all times, and that Parent will be notified of any problems or concerns with Parent’s or Child’s compliance with this Agreement. In the event Parent is unable to correct any such concern or problem, and in the sole discretion of Provider such issue is considered to raise concerns over the safety of any other student, or such issue in any way affects Provider’s ability to safely and properly conduct the Program for other students, Child will not be allowed to return.
V. Representations Before Signing Agreement. I further agree that this Release shall be governed by and construed in accordance with the laws of the State of Utah without regard to its conflicts of law provision and not against the drafter. These terms are contractual and not a mere recital. The Parties further agree that all disputes, if needed, shall be resolved exclusively in state court in South Ogden, Weber County, Utah. The failure by Provider to exercise any right, power or option given hereunder, or to insist upon the strict compliance with the terms and conditions hereof by Child or Parent, shall not constitute a waiver of the terms and conditions of this Agreement with respect to any other or subsequent breach thereof, nor waiver by Provider of its right at any time thereafter to require strict compliance with all terms and conditions hereof. If any term or provision of this Release shall be held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected thereby. All provisions of the Release are binding upon me, my heirs, successors and assigns and their estate. This is the entire agreement between me and Provider. BY SIGNING THIS AGREEMENT, I REPRESENT AND SPECIFICALLY WARRANT THE FOLLOWING: (a) I am the parent or legal guardian of Child, and have full authority to execute this Release; (b) I have had ample opportunity to read this Release and have so done; (c) I fully understand and voluntarily agree to each term herein; (d) I am under no duress or requirement to sign this Release; (e) I have not been induced to sign this Release by the statement or conduct of Provider; (g) I have the personal mental competency and legal capacity to understand and enter into this Release on behalf of myself and Child; (h) I am over the age of 18.
to Provider to use my or Child’s photograph and image or all purposes including publicly. I grant all and exclusive right, title and interest in any and all photographs, videos, and such likenesses without any limitations whatsoever, to Provider to use such images in any manner they may choose including in print or online publications, websites, advertising, and social media, including use for profit. I also understand that no royalty or other compensation shall be payable to me by reason of such use. I agree that all such images, together with any prints, proofs, and/or electronic data are the exclusive property of Provider.
Release of Liability
VII. Release of Liability. This is a release of legal rights. Read and be certain you understand before signing.
I/Parent do hereby in advance waiver release, acquit, forever discharge, and covenant not sure provider, its owners, agents, employees, and all persons and entities (“released parties”) of, from any/all causes of action, claims, demands, damages, costs, loss of services, expenses, and compensation, on account of or in any way growing out of any and all personal property damage or personal injuries including death resulting from my child’s attendance of the program, or any emergency medical treatment authorized under this agreement. Should I or my successors assert any claim in contravention to this agreement, I and my successors shall be liable for all expenses including legal fees incurred by released parties in defending unless released parties are adjudicated finally liable on such claim for intentional acts or gross negligence. The release extends to and includes, but is not limited to, all damages of every kind, including compensatory, statutory, contractual, and damages under warranty, allegedly occurring both in the past and which allegedly may occur in the future, which could be asserted by me (parent), child, or by others claiming damages from any injuries I or my child may sustain as a result of my execution of the agreement or child’s participation in the program including all pre-judgement and post-judgement interest and any and all other damages, losses and expenses of every kind, known or unknown, and which are or may be attributable to released parties.