In the 
Saratoga Shopping Center:
8060 Rolling Rd, Springfield, VA 22153

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703-277-3400

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Designed by Peter Kim

© 2016 The Science Place. All Rights Reserved

Waiver

Waiver:

READ CAREFULLY WAIVER AND RELEASE OF LIABILITY

In consideration of The Science Place furnishing services and/or equipment to enable me to participate in various science experiments and the handling of various animals, I agree as follows: I fully understand and acknowledge that; (a) risks and dangers exist in my participation in various scientific activities and use of any lab equipment; (b) my participation in such activities and/or use of such equipment may result in injury or illness including but not limited to bodily injury or disease strains (c) these risks and dangers may be caused by the negligence of the owners, employees, officers, agents or contractors of The Science Place; the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. These risks and dangers may arise from foreseeable or unforeseeable causes; and (d) by my participation in these activities and/or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether causes in whole or in part by the negligence or other conduct of the owners, agents, officers, employees, and contractors of The Science Place, or by any other person. I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify The Science Place and its owners, agents, officers, employees and contractors from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my use of any scientific lab equipment or my participation in any activities. I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers, employees or contractors of The Science Place. This waiver is good until 12/31/17.

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MEDICAL PERMISSION AUTHORIZATION

If the participant is of minority age, the undersigned parent or guardian hereby gives permission for The Science Place to authorize emergency medical treatment as may be deemed necessary for the child named below while participating in Science Place activities from this date through 12/31/17.

 

I HAVE READ THE ABOVE WAIVER AND RELEASE AND, BY SIGNING IT, AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE THE SCIENCE PLACE FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH DUE TO NEGLIGENCE OR ANY OTHER CAUSE. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT AND SUBMITTING THIS FORM, AND I AM SIGNING IT AND SUBMITTING THIS FORM FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

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