Consent Release Banyan Odyssey RELEASE, HOLD HARMLESS AND INDEMNITY Agreement URLThis field is for validation purposes and should be left unchanged.Consent(Required) I agree to the policy.I RELEASE, HOLD HARMLESS and hereby agree to INDEMNIFY the Banyan Odyssey, Inc. (Banyan Program), its programs, agents, servants, employees and/or volunteers from any and all liability, claims, causes of action or suits, for the loss or damage of property, or for injury to, or the death of, my child (ward) or others, for damages, losses, expenses, attorney fees, or costs of whatever nature sustained by me, my child (ward) or others, which may arise out of, or in connection with, my child’s (ward’s) use or occupancy of the Banyan Program’s premises or participation in Banyan Program activities or programs, regardless of the nature or extent of such injuries, damages, costs, expenses, attorney fees or losses, or whether such injuries, damages, costs, expenses, attorney fees or losses are caused in whole or in part by the negligence or sole negligence of the Banyan Program, its agents, servants, employees and/or volunteers, or caused in part by the negligence of the Program, its agents, servants, employees and/or volunteers and the negligent or grossly negligent acts or omissions of my child (ward) or any other person or entity. This Release, Hold Harmless, and Indemnity Agreement is to be construed broadly, but it does not serve to release or waive claims or causes of action to which my child (ward) may be entitled due to personal injury. I hereby grant permission to, and request and authorize all physicians, nurses and hospitals and their authorized employees and designees to perform routine diagnostic procedures and render medical care deemed necessary for my child (ward). I understand and confirm that regardless of my assignment of insurance benefits, I am responsible for the total charges incurred by the Banyan Program or others for medical care or services rendered to or on behalf of my child (ward). I understand the Banyan Odyssey, Inc. in no way covenants the condition of any personal article or item of property brought to the Banyan Program by my child/ward, and that unnecessary valuables are not to be brought to events. The Banyan Odyssey, Inc. agrees to keep updated insurance for sponsored activities and educational programs related to the mission of the 501(C)(3).Participant’s Full Name:(Required) First Last Signature(Required)Date Month Day Year CAPTCHA Δ