Thank You – EarlyON Barrie Snoezelen Room

Rights and Responsibilities Waiver

If this is your first time visiting, please review and sign the following Rights and Responsibilities waiver

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)s attendance at the Empower Simcoe EarlyON Child and Family Centre Snoezelen room.

On my behalf, and on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless Empower Simcoe, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Empower Simcoe, its employees, agents, and representatives.  By signing this agreement, I acknowledge the truth of the following:

• I have received orientation in the safe and proper use of the Empower Simcoe community Snoezelen room by an Empower Simcoe staff.
• I understand the philosophy of Snoezelen and the reason my child is using the room.
• I understand the guidelines around using the room and I agree to follow these instructions.
• I recognize the need for a hygienic environment. I agree to leave the room clean and orderly.
• I recognize that the room has been made as safe and secure as possible.
• I have been made aware of any possible risks and consequences that are associated with using the Snoezelen room.
• I recognize my responsibility to provide support for my child or person supported at all times. I am aware that this means direct supervision.
• I agree to assume responsibility for any inappropriate behaviour and / or damage which occurs during the course of my visit to the Snoezelen room.
• I understand that and EarlyON Facilitator may stop my session at any time, for health and safety reasons.