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2. POST Partners Waiver & Indemnification Form
4. Organization (if applicable):
5. Outing Date:
   Outing Date:
7. Outing site location:
9. Participants Name:*
10. Birth Date:*
    Birth Date:
11. Gender:*
    -- Select One --MaleFemale
13. Parent/Guardian Name:
    (if signing for minor)
14. Relation to Child:
16. Mailing Address (City/State/Zip):*
18. Primary Phone:*
19. Alternate Phone:
20. Email Address:
24. Feel free to include other family members on this same waiver, please include their names and birth dates:
26. Family Member Name:
27. Birth Date:
    Birth Date:
29. Family Member Name:
30. Birth Date:
    Birth Date:
32. Family Member Name:
33. Birth Date:
    Birth Date:
35. Family Member Name:
36. Birth Date:
    Birth Date:
38. Family Member Name:
39. Birth Date:
    Birth Date:
43. I hereby grant the Town of Castle Rock and the Parks and Recreation Department the right and license to use my or my child’s name, image, likeness and comments in Castle Rock materials for internal and external audiences. These materials include, but are not limited to, advertisements, brochures, annual reports, newsletters, videos and the Town's website. *

    1. Yes
    2. No
47. WAIVER FOR PARTICIPATION*

    All exercise and participation done is at the risk of the user or parent of the user. The Town of Castle Rock is not liable for personal injury, theft, or loss of property. By signing below, you assume full responsibility for yourself and/or your children for any injuries, damages or losses which may occur and do hereby fully and forever release and discharge the Town of Castle Rock and its employees from any claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of your use of facilities and equipment. By signing this form, the participant agrees to follow and abide by all set parks and open space rules and regulations. By signing this form, I indicate that I have read the above and fully understand and agree with the terms and conditions.

    1. Accept
49. Electronic Signature:*
    Please type your First and Last Name. Typing your name above constitutes a legal signature whereby you are confirming the information provided in this form is true and correct to the best of your knowledge, that you are a parent or legal guardian of the participant, and that you acknowledge and agree to the above Waiver for Participation and Personal Release Statement.
50. Today's Date:*
    Today's Date:
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field