Trust Fund Family Participation & Waiver Agreement

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(Including assumption of risks and agreements of release and indemnity) 

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In consideration of being allowed to participate in the amusements and activities offered in conjunction with the UAW/UMass Health & Welfare Trust Fund (the “Fund”) I, for myself, my heirs, personal representatives and assigns acknowledge and agree as follows (for myself and on behalf of any children I am bringing to the event):

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General Agreements

I understand and agree to the following participation agreement and waiver for participation in the summer retreat.

 

• I must remain in Furcolo Hall for the duration of the retreat and I am responsible for my child at all times. 

• I agree to respond immediately to staff contact during the retreat.
• I agree to inform retreat staff of any of my child’s allergies or other medical conditions that would help staff maintain the child’s health and safety during programming.
• I agree to address any first aid needs or medical emergencies with my child during programming.
• I agree to allow retreat staff to provide positive guidance while supervising my children and understand that retreat staff are prohibited from using physical discipline (spanking, slapping, etc.) or verbal discipline (yelling, belittling, etc.) with children.
• I agree to work with retreat staff to address my child’s needs if the child’s behavior exceeds staff’s capacity at any time.
• I agree to change my child’s diaper or attend to toileting needs as needed. *Retreat staff are prohibited from changing diapers and assisting with toileting.
• I agree to refrain from attending the retreat if my child exhibits any of the following symptoms: positive COVID test within last 5 days, fever of 100 degrees or more in the last 24 hours, vomiting or diarrhea in the last 24 hours, excessive coughing or nasal discharge, draining sore or rash, symptoms of other communicable conditions or disease.

• The retreat is designed for children who are able to function successfully in a group setting. I agree that if, in the judgment of the retreat and it's staff, a child is not able to function in a group setting, or the staff is not able to meet the needs of a particular child, staff may require the parents onsite to withdraw the child from the retreat setting.

• I agree to communicate with the retreat staff with any concerns or questions regarding programming. If parents are needing further assistance with their concerns or questions, they should contact Trust Fund Director, Leslie Edwards Davis, at uwdental@umass.edu or 413-200-0423.

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Activities and Risks

I understand that I am responsible for managing the risks of my activities while on the University of Massachusetts (the "University") campus, supervised or not, including not participating in an activity for which I feel I am not qualified or which includes harmful conditions. I understand that I must follow all venue policies, rules, and regulations. I acknowledge that event staff is, and has been, available, to answer any questions about the nature and physical demands of the activities and their risks. I understand that the risks of the activities include, among others, the following: (1) misuse of the equipment or facilities; (2) falls and abrupt and possibly harmful contact with persons, structures and objects (fixed and moveable); (3) failure of the facilities and other equipment; (4) mental or physical health problems of participants and others; (5) lack of training and conditioning; (6) consumption of food or beverages served; and (7) carelessness and misjudgements, including negligence, of participants and staff. I understand that I must follow all University policies, rules, and regulations as well as the policies, rules, and regulations of the particular activity. 

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Assumption of Risks​

My attendance at the summer retreat, study lounges, or other family-friendly activities, such as the Family Art Night, is voluntary. I hereby acknowledge the risks described above and their inherency, and that other risks, known and unknown, inherent and otherwise, may be encountered. I expressly and knowingly assume all the risks, known and unknown, inherent or not, and whether or not described above, of attending family-friendly activities and transportation to or walking to those activities.

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Release and Indemnity

I, my heirs, personal representative or assigns do hereby agree (to the maximum extent allowed by law), to release and discharge the Fund from, and covenant not to sue (or otherwise assert a claim against) the Fund, its trustees and its staff with respect to, any and all claims (resulting in personal injury, accidents, or illness, including death), liabilities and losses in any way arising from or connected with my attendance at family-firendly activities, the use of equipment, materials and facilities, or otherwise moving about the premises. 

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I further agree to hold harmless and indemnify (that is, defend and pay or reimburse) the Fund, its trustees and its staff from any claim and from any liability, loss, damages or expenses (including attorneys’ fees) resulting from my attendance at family-friendly activities.

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Additional Provisions

I acknowledge and agree that I have carefully read, understand the University's policy on minors on campus. I understand I am responsible for mychild(ren)’s safety at all times and that child(ren) should never be left unattended by me at any family-friendly event at any time.

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I acknowledge and agree that I have carefully read, understand and voluntarily sign this Agreement and acknowledge that it shall be effective and binding upon me and my family, heirs, executors, administrators and representatives. I agree that this Agreement is intended to be as broad and inclusive as permitted by the law of the State of Massachusetts and if any portion of this Agreement is held by a court of competent jurisdiction to be invalid, the balance of this Agreement shall continue in full force and effect.

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