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Mount Holly walks for Wellness

Welcome to the Mount Holly Walks for Wellness Sign -Up Page.  Please fill out the below form if you are interested in participating.

Sign Up Form

 



ASSUMPION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENTRELATING TO COVID-19 EXPOSURE, COVID-19 LIABILITY, AND COVID-19 RISKS IN CONSIDERATION for myself and/or my children listed above being permitted to utilize the services, utilize the facilities and/or participate in the programs of Mount Holly Township(the “Organization”), including, but not limited to, observation or use of facilities or equipment, or participation in or acting as a spectator during any program affiliated with Mount Holly Township, the undersigned, on behalf of himself or herself and such participating children and any personal representatives, heirs, and next of kin (hereinafter referred to as "the undersigned") hereby acknowledges, agrees and represents that he or she has inspected and carefully considered such premises, equipment, and facilities and has considered Mount Holly Township’s programs and that the undersigned finds and accepts same as being safe and reasonably suited for the use or participation by the undersigned and such participating children. In addition, the undersigned acknowledges that novel coronavirus (''COVID-19") infections have been confirmed throughout the United States, including several cases in the undersigned’s own State and locality. In accordance with the most recent guidance and recommendations issued by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC),undersigned’s own State’s Department of Health (DOH) for slowing the transmission of COVID19, the undersigned hereby agrees, represents, and warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services, and/or programs of Mount Holly Township (other than any exclusively online services and programs) within 14 days after (i)returning from highly impacted areas subject to a CDC Level 3 Travel Health Notice, (ii)exposure to any person returning from areas subject to a CDC Level 3 Travel Health Notice, or(iii) exposure to any person who has a suspected or confirmed case of COVID-19. The CDC Travel Health Network is continuously updating this list and the undersigned agrees that they are aware of this list and the countries listed. The undersigned agrees to check on a daily basis the CDC Travel Health Notices list (https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html)prior to participating in or utilizing the facilities, services, and programs of Mount Holly Township. The undersigned hereby agrees, represents, and warrants that neither the undersigned nor such participating children shall participate in, visit or utilize the facilities, services, and/or programs Mount Holly Township if he or she (i) experiences symptoms of COVID-19, including, without limitation, fever, cough, loss of sense of taste or smell, or shortness of breath, or (ii) has a suspected or diagnosed/confirmed case of COVID-19. The undersigned agrees to notify Mount Holly Township immediately if he or she believes that any of the foregoing access/use restrictions may apply .Mount Holly Township has taken certain steps to implement certain recommended guidance and recommendations issued by public health agencies for slowing the transmission of COVID-19,including, without limitation, the access/use restrictions set forth above. The undersigned acknowledges and agrees that Mount Holly Township may revise its procedures at any time based on updated recommended guidance and recommendations issued by public health agencies and further agrees to comply with Mount Holly Township’s revised procedures prior to utilizing the facilities, services, and/or prior to participating in the programs of Mount Holly Township. The undersigned further acknowledges and agrees that, due to the nature of the facilities, services, and programs offered by Mount Holly Township, social distancing of 6 feet per person among children and their fellow participants or others is not always possible. The undersigned fully understands and appreciates both the known and potential dangers of participating in the programs and/or utilizing the facilities and services of Mount Holly Township and acknowledges that use thereof by the undersigned and/or such participating children may, despite Mount Holly Township’s reasonable efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/ordeath.IN FURTHER CONSIDERATION OF BEING PERMITTED TO PARTICIPATE INMOUNT HOLLY TOWNSHIP PROGRAMS, THE UNDERSIGNED HEREBYAGREES TO THE FOLLOWING:THE UNDERSIGNED, ON HIS OR HER BEHALF AND ON BEHALF OF SUCHPARTICIPATING CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGES ANDCOVENANTS NOT TO SUE Mount Holly Township or its local governing body organization, or any of their respective directors, officers, employees, volunteers and agents, or any of the fellow participants or their family members or guests from all liability to the undersigned or such participating children and all personal representatives, assigns, heirs, and next of kin of the undersigned or such participating children for any loss or damage, and any claim or demands on account of any property damage or any injury to, or an illness or the death of, the under signed or such participating children (or any person who may contract COVID-19, directly or indirectly, from the undersigned or such participating children) whether caused by the negligence, active or passive, of Mount Holly Township or otherwise while the undersigned or such participating children are in, upon, or about the premises or any facilities or using any equipment of or participating in any program of or affiliated with Mount Holly Township. To the extent such statute applies, the undersigned also expressly and knowingly waives all rights under California Civil Code Section 1542, which provides: "A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party. "THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS Mount Holly Township or its local governing body organization, or any of their respective directors, officers, employees, volunteers and agents, and each of them, from any loss, liability, damages or costs they may incur, whether caused by Mount Holly Township’s negligence, active or passive, or otherwise while the undersigned or any participating child is participating in any program of Mount Holly Township or in, upon, or about the premises or any facilities or equipment affiliated with the Mount Holly Township. The undersigned understands and agrees that Mount Holly Township is not required to provide insurance to cover the undersigned or such participating children in the event they suffer illness, injury, death, property loss, theft or damage of any sort upon, or about the premises or any facilities or equipment therein or while participating in any program affiliated with Mount Holly Township. The undersigned agrees and acknowledges that use of Mount Holly Township facilities and services, and participation in Mount Holly Township programs, may involve inherent danger and risk, including, without limitation, the risk of physical illness or injury, death or property damage. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBIUTY FOR, AND RISKOF ILLNESS, BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned or such participating children due to negligence, active or passive, or otherwise while in, about or upon the premises of Mount Holly Township and/or while using the premises or any facilities or equipment thereon and/or while participating in or observing any program affiliated with the Mount Holly Township. The undersigned acknowledges that any illness or injuries that the undersigned or such participating children contract or sustain may be compounded by negligent first aid or emergency response of the Releases and waive any claim in respect thereof. THE UNDERSIGNED further expressly agrees that the foregoing ASSUMPTION OF RISK,RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State in which the undersigned resides or participates and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I HAVE CAREFULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK,RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHERAGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APARTFROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THATBY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS,INCLUDING THE RIGHT TO RECOVER DAMAGES FROM MOUNT HOLLY TOWNSHIP INCASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE, INCLUDING, FORTHE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID-19 ATANY MOUNT HOLLY TOWNSHIP FACILITY OR DURING PARTICIPATION IN ANYPROGRAM AND ANY ILLNESS, INJURY OR DEATH RESULTING THEREFROM. IUNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OFAND INDEMNIFICATION FOR ALL CLAIMS. IF SIGNING ON BEHALF OF MINOR: I ALSOUNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILD(REN)AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT TO MOUNT HOLLYTOWNSHIP THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OFSUCH MINOR(S).I have read and understand the terms of this Assumption of Risk, Release and Waiver of Date Liability, and Indemnity Agreement and agree to its terms. Signature Emergency Contact Name Emergency Contact Number