City of Edina Form Center

By checking the box, you certify that you have read the above listed inventory and the information contained therein is true and accurate.

In consideration of your acceptance of me or my child as a participant in a City of Edina program, I hereby waive all claims against the City of Edina, its employees and its agents, and I release the City of Edina, its employees and its agents from all claims for all injuries suffered by me or my child incidental to, connected with, or arising out of the recreational activities for which my child or I am enrolled, including injuries suffered as the result of negligence by the City of Edina or its employees or agents, but not including injuries suffered as a result of their willful or intentional misconduct or gross negligence. If registering for a child, I give my approval for my child's participation in all City-sponsored activities during the current season. I understand that the program for which I have enrolled or given my child permission to participate in may be hazardous and that injuries may occur in the normal course of participation or instruction. I assume all risks and hazards incidental to my child's or my participation, including transportation to and from the activities. I also understand and acknowledge that the City of Edina has no medical or health insurance covering me or my child. I understand that City of Edina staff or their representatives may photograph participants enrolled in programs, classes or events or enjoying park facilities. These photographs become the sole property of the City and may be used in future publications and websites. I also understand that the information I have provided will be made available only to program staff, the City of Edina's insurer and attorney and volunteers connected with the program for the purposes of administering the activity and providing parents and children with information regarding scheduling and scheduling changes.

The Minnesota Data Privacy Act requires that we inform you of your rights about the private data we are requesting on this form. The following data contained on this form will be considered private data pursuant to M.S. 13.548: the name, address, telephone number, any other data that identifies the individual, and any data that describes the health or medical condition of the individual, family relationships, and living arrangements of an individual or which are opinions as to the makeup or behavior of an individual. We need this data to register you for a program and to contact you if necessary. Edina staff will have access to the data you provide to administer the program. You are not legally required to provide the data; however, refusing to supply the data may cause your registration to not be processed. Your acceptance here indicates you have read and understand these rights.