Hunterdon County Makerspace Activities Program
Minor Child Individual Release
Program Date: _____________________ Program Location:_____________________________
Childs Name: ______________________________ Childs Date of Birth:___________________
Parent/Guardians Name:________________________________ Phone:____________________
Emergency Contact Different from above:____________________________________________
IMPORTANT: Photographs will be taken at this event. If you do not wish to have your photograph taken, initial below.
I do NOT give permission to use any photos of myself taken during this program for publicity or program literature: _______(initial)
I understand that participation in any of the Hunterdon County Makerspace Activities Programs may involve activities which pose a potential risk of personal injury. Some examples of these activities include, but are not limited to, virtual reality, video production equipment, recording devices, circuit boards, electrical wiring, electronic equipment, saws, drills, screwdrivers, wood and metal working tools, heat press, pottery equipment and ceramic materials, a mobile culinary cart, 3D printing and scanning machines, Co2 laser equipment, computer equipment, sewing, embroidery and serger machines, drawing tools and equipment, soldering stations and wood, metal, plastic and composite supplies and materials, glue, solvents, glaze, nails, screws, and other working parts.
While most tools, equipment, and supplies will be provided by HCL, on occasion such items will be supplied by users.
Minor User may work alone or share Makerspace workspace, tools and equipment with other users and HCL staff and must be accompanied by their Parent/Guardian at all times. HCL may require users to wear specified safety gear, and undergo training. Surfaces of floors, work benches and tables in Makerspace areas may have debris, dust, liquids, and sharp objects.
The Parent/Guardian, for and on behalf of the Minor User understands and agrees that the Makerspace Activities involve various hazards, dangers, and risks, including without limitation, and by way of example, the risk of trips, slips and falls; cuts, broken bones, burns, and other wounds to hands, head, feet, eyes and other body parts; electrical shock; exposure to dust, fumes, smoke, noise, and vibrations; and accidents due to negligence of other users or HCL staff or vendors, or due to defective or inadequate facilities, equipment, tools, machinery, or due to inadequate maintenance or repair, training, instructions, supervision, first aid and medical treatment, or safety gear. The risks also include other risks arising from Minor User’s involvement in the Makerspace Activities.
The Parent/Guardian agrees that the Minor User’s participation in Makerspace Activities involves risks of accidents and serious personal injury and illness, paralysis, permanent disability, and even possibly death of the Minor User. All above-referenced risks and other risks arising from the Makerspace Activities are referred to herein as the "Risks".
The undersigned Parent/Guardian expressly assumes for such Minor User, and the Parent/Guardian, and their heirs, family and estate, executors, administrators, assigns and personal representatives, all Richs arising from the Minor User’s participation in Makerspace Activities, whether those Risk are known or unknown, or are predictable or unpredictable, or are Ricks inherent in the Makerspace Activities.
I assume all risks associated with participation in the program for Minor User, their heirs, executors and administrators waive and release The County of Hunterdon its governing body, officers and employees, volunteers, Board and Commissions, from all claims, liability, risk of loss or injury and damages of any kind including wrongful death associated with or arising out of Minor User’s participation in the proposed program work.
HCL does not create or claim ownership of patron content created within the Makerspace or with use of Makerspace equipment. Each patron affirms they are not breaking any copyright laws in the process of creating such content. Any person who knowingly infringes upon copyright policies will be solely liable for any actions taken and will not involve the HCL, its Board of Trustees, and all organizations related to HCL. For further information on copyright infringement go to: https://www.copyright.gov/title17.
The parties intend each provision to be severable and separate and apart from one another. The parties agree that any and all disputes resulting in litigation will be commenced, litigated, and adjudicated only in the County of Hunterdon, State of New Jersey pursuant to the laws of the State of New Jersey.
If a court of law construes that any part of this release is invalid, such construction shall not invalidate the remainder of this release.
By my signature, I acknowledge that I have carefully read this Agreement in its entirety and understand it, and I voluntarily agree to all statements and provisions of the Agreement. I am sufficiently informed about the Makerspace Activities in which I will participate, and the Risks involved to decide whether to sign this Agreement. I authorize the Minor User to participate in the Makerspace Actives. I attest that I am the parent, or legal guardian, or otherwise responsible person, of the Minor User with full authority under the law to sign and enter into this Agreement for the Minor User.
I certify that I have reviewed and understand the Safety Guidelines. I understand that while those materials contain instructions intended to protect me from injury, even my full compliance with those instructions will not guarantee that no injury will occur.
Parent/Guardian Name: _______________________________________________(please print)
This form needs to be printed, signed and returned/uploaded back to the Program Coordinator. A digital signature on a Minor Child Individual Release will not be accepted.
314 State Route 12, Bldg. #3
Flemington, NJ 08822