NCE ADULT WAIVER/INDEMNIFICATION FORM
I do hereby CONSENT to my participation in NCE program(s), which are voluntary and sponsored by Newton Community Education. I release and discharge NCE and the City of Newton and its departments, officers, employees, and agents (hereinafter collectively referred to as “Newton”), from any and all claims, damages, losses or expenses of whatever kind or nature which I may have or acquire arising out of or resulting, directly or indirectly, from my participation in NCE program(s). I further agree to defend and INDEMNIFY Newton and NCE against any claim, damage, loss or expense of whatever kind or nature that Newton may have to pay that arises from my intentional, grossly negligent, or reckless acts or omissions while participating in the NCE program(s).
If I am participating in virtual NCE program(s), I hereby CONSENT to my participate remotely through platforms including but not limited to Zoom. I hereby give permission for NCE instructors to communicate with me by video link, email, text messaging or using other online tools offered by the NCE instructors. I further understand and agree that my image and voice will be transmitted over the internet, into the homes of other NCE students and NCE instructors. I understand that NCE cannot guarantee or warrant confidentiality of my voice, image or other information while participating in NCE program(s).
I further agree that I will review and comply with all applicable NPS policies and procedures located at https://www.newton.k12.ma.us/page/2902 including but not limited to the NPS Acceptable Use Policy for virtual NCE programs, and all NCE and NPS policies and procedures pertaining to COVID-19 (for more information and health assessment tools, please visit https://www.newton.k12.ma.us/Page/3897 and http://www2.newtoncommunityed.org/about-us/policies/).
I attest that I am physically fit to participate in NCE program(s). I authorize Newton’s employee(s) or agent(s) and/or NCE instructors to assist on my behalf in authorizing and consenting to emergency medical care should I become ill or injured while participating in NCE program(s). This authorization and consent may be presented to the appropriate emergency medical staff at such time as emergency medical care is required. I RELEASE and discharge Newton from any and all claims of any nature whatsoever that may arise out of the decision to provide emergency medical care.
I further authorize NCE or its representatives, to photograph, digitize, or otherwise preserve in permanent form my likeness and/or image. I give permission for my likeness or image to be published on NCE’s website, social media page, and other NCE print or media publications or communications. No personally identifying information, including name, home address, or telephone number would appear on such picture, photo or video. I understand that I may revoke my authorization for NCE or its representatives to preserve or publish my likeness and/or image at any time in writing to the Director of NCE.
