Waiver of Liability

This waiver releases Little Medical School, from all liability relating to injuries that may occur by using my child Little Medical School take home Items outside the classroom setup.
Please note that all items are safety tested. However, parents need to be aware of materials safety.

Parent Name*
First Last
Child Name*
First Last
Child Name*
First Last
Additional Child*
- Yes
- No
Program Location*
If you selected community centre above, please mention the name of the centre.
This includes City of Ottawa Centres, Community Association Centres, Recreation Complex and Community Resource Centres.
If you are part of a school board, community group or other organization, please mention the name of your institution.
Name of the Program
Date*
MM slash DD slash YYYY
Email
Phone*
Waiver of Liability*
I have checked the material safety guide, and I agree to the waiver of liability
I have read the risks and I agree to hold Little Medical School, or any staff member, entirely free from any liability, including financial responsibility for injuries incurred during the sessions or while using the take-home items outside the classroom settings. I understand these risks are the most common, thus other risks that are not listed might occur. I also acknowledge that I voluntarily accept the participation of my child and that I have been fully informed of all material risks and am giving my full and informed consent. Additionally, my child does not have any condition that will increase the likelihood of experiencing injuries while engaging in this activity.
By signing below, I forfeit all right to bring a suit against Little Medical School, for any reason. In return, my child will participate in the sessions and receive their take-home items. I will also make every effort instruct my child to obey safety precautions as listed in writing and as explained to them by LMS instructor. I will ask for clarification when needed.
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