I authorize Voices for Children to transport the Child(ren) in a vehicle driven by an individual authorized by Voices for Children as part of the Child(ren)’s participation in Voices for Children’s youth engagement activities, events, and workshops. I understand that Child(ren) is/are expected to follow all applicable laws regarding riding in a motor vehicle and is/are expected to follow the directions provided by the designated driver and/or staff or volunteer.
1. I am a parent or designated guardian of Child(ren) and I have the legal authority to grant permissions described in this Transportation Liability Waiver.
2. I understand that Voices for Children’s offered transportation is not a requirement for participation in any program of Voices for Children.
3. I have read, understand, and discussed with Child(ren) the following:
a. Child(ren) will travel in a motor vehicle driven by a designated adult;
b. Child(ren) must wear their safety belt during travel;
c. Child(ren) is/are expected to listen to reasonable instruction from a supervising staff member and/or driver, and to respect all staff, other children, other riders, and the vehicles they ride in;
d. Child(ren) is/are to remain in their seat and not be disruptive to the driver of the vehicle.
Voices for Children retains the right to remove disruptive Child(ren) from a vehicle, activity, or program for the Child(ren)’s failure to comply with these reasonable passenger rules.
4. Child(ren) and I recognize that participation in this activity, as with any activity involving motor vehicle transportation, may risk personal injury, disability, permanent loss, or death. These may result not only from Child(ren)’s own actions, inactions, or negligence, but also from the actions, inactions, or negligence of others (including other riders, drivers, or pedestrians), or the condition of the facilities, equipment, or vehicles. Further, there may be other risks not known to me or reasonably foreseeable at this time. I understand and I have considered the risks involved, and I voluntarily and freely choose to assume these risks on behalf of Child(ren). I hereby attest and verify I have been advised of the potential risks, and I have full knowledge of the risks involved in this activity, and I assume any expenses incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses.
5. By signing this Transportation Liability Waiver, with full appreciation of the risk involved, on my own behalf and on behalf of Child(ren), I hereby voluntarily release, discharge, and hold harmless Voices for Children and its affiliates, successors and assigns, officers, board members, employees, volunteers, representatives, partners, agents and anyone claiming through them, in their individual and/or corporate capacities, (“Releasees”) from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, arising out of or in any way connected with Child(ren)’s transportation provided by Voices for Children, other than claims arising from the Releasees’ gross negligence or willful misconduct.
6. As a condition for the transportation received, I (for myself, the Child(ren), my executors and assigns) further agree to release and forever discharge Voices for Children and the Releasees from any claim that I might have myself or that I could bring on the Child(ren)’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation, other than claims arising from the Releasees’ gross negligence or willful misconduct.
7. I further consent to Child(ren)’s receipt of medical treatment deemed necessary if Child(ren) is/are injured or requires medical attention during participation in these youth engagement activities. I hereby release, forever discharge, and hold harmless Voices for Children and all other Releasees from any claim based on such treatment or other medical services.
8. Other Terms:
a. Entire Agreement: This Release constitutes the sole and entire agreement of Voices for Children and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter.
b. Severability: If any term or provision of this Release is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or invalidate or render unenforceable such term or provision in any other jurisdiction.
c. Binding Effect: This Release is binding on and shall inure to the benefit of Voices for Children and me and our respective heirs, successors, and assigns.
d. Governing Law and Venue: All matters arising out of or relating to this Release shall be governed by and construed in accordance with the laws of the State of Nebraska, without giving effect to any choice of law or conflict of laws principles. Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in Douglas County, Nebraska and I hereby consent to the exclusive jurisdiction of such courts.
I have read this entire waiver and authorization form, I fully understand its terms and conditions, and I agree to be legally bound by its terms.
By signing this form, I confirm that I have read and understood the terms outlined above.
I freely and voluntarily give my consent for Child(ren) to participate in the activities, programs, or services described. I understand the responsibilities, requirements, and any potential risks involved.
