Aisha Cultural Center
Aisha Cultural Center Facilities Consent and Liability Release Form
I am a parent/guardian signing up on behalf of my child(en)I am 18 Years or older signing for myself
Full name
Date of birth:
Phone Number
Email:
------------------------------------------------------ Child 1 Information: Name
Date of birth: -------------------------------------------------------
Child 2 Information: Name
Date of birth: ------------------------------------------------------- Child 3 Information: Name
Date of birth: --------------------------------------------------------
I hereby consent to use all of the Aisha Cultural Center Sport facilities and playground equipment’s and to play at the facility located at Aisha Cultural Center 1311 Hancock Lone Palm Rd Orlando, FL 32828. I understand and acknowledge that the use of outdoor facilities including the sport facilities involves risks including possible risk of injury to myself. I am choosing to use the facilities at my own risk. I assume full responsibility for all risks that may arise from my playing at the facility located at Aisha Cultural Center
I hereby release, waive, discharge, and hold harmless Aisha Cultural Center and its representatives and employees from any claims, suits, liabilities, judgments, costs and expenses for any property damage, loss or theft, personal injury, illness or other loss arising from the use of the sport facilities located at Aisha Cultural Center. This acknowledgment of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent
Date:
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