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Mindful Eating Registration

  1. Los Altos Hills Resident

  2. Dates Attending

  3. Waiver Release and assumption of risk. In consideration of the acceptance of my participation in this event, I hereby release and discharge any and all claims for damages, death, personal injury or property damage which I (or my minor child, if applicable) may have, or which may hereafter accrue to me (or my minor child) as a result of my (or my minor child’s) participation in this event. This release is intended to discharge in advance the Town of Los Altos Hills and its officials, agents, volunteers, employees and roadway or pathway property owners from and against any and all liabilities arising out of or connected in anyway with my participation (or minor child’s participation) in this event, even though that liability may arise from their negligence in organizing, planning and implementing this event. I further understand that accidents can occur during the event and participants in such events can sustain personal injuries and/or property damage as a consequence. Knowing the risks, nevertheless, I hereby agree to assume those risks and to release and discharge all of the persons or agencies motioned above who (through negligence or carelessness) might otherwise be liable to me (or minor child or my heirs or assigns) for losses, injuries, damages or liabilities. It is further understood and agreed that this waiver, release, and assumption of risk is binding on my heirs, executors, administrators, and assigns (and on my minor child, if applicable). In addition, should the Town of Los Altos Hills take photographs this program, event or activity; I agree to allow use of photograph to be used for program publicity purposes only.

  4. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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