06 Participation Agreement (View)

In consideration of my child, a minor under the age of eighteen years, being afforded the use of the facilities of the U.S. Marine Corps and Devil Pups, Inc., I do hereby release and discharge the United States of America and officers and employees and other personnel of the United States Marine Corps, United States Navy and Marine Corps Base, Camp Pendleton, California, and Devil Pups, Inc., its agent and employees for all claims of damages, demands and action whatsoever in any manner arising from my child’s participating in the Devil Pups Program.

Nothing herein is to constitute a waiver of any right that my child has to medical treatment based upon his/her status as a military dependent of an active duty member of the U.S. Armed Forces or a retiree of the United States Armed Forces.

I attest and verify that I have full knowledge of the risks involved in this activity and that he/she is physically fit and sufficiently trained to participate therein.

I understand that if my child is injured or becomes ill while at Devil Pups, he/she will be given medical treatment, and I hereby authorize and consent to any X-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by and rendered under the general supervision of U.S. Naval Medical or Civilian Medical personnel. I further agree to pay the cost of any such care and treatment. In the event I have health insurance which provides benefits for my child, I hereby assign such benefits payable to me for the medical care and treatment and the hospitalization of my son/daughter to the U.S. Navy and/or the U.S. Marine Corps operating the medical facilities providing such care and treatment.

I understand and agree to pay the cost of transportation of my child from Camp Pendleton to my home should my son/daughter leave the program either at my request or the request of Devil Pups, Inc., prior to completion of the program. Should my child for any reason, miss the scheduled transportation provided immediately following graduation, I will Pay for his/her transportation home. My child will bring $40.00 cash to the encampment to cover incidental items.

I HEREBY CERTIFY THAT MY SON/DAUGHTER IS NEITHER EPILEPTIC NOR ASTHMATIC AND HE/SHE DOES NOT HAVE CONGENITAL DEFECTS WHICH MAY BE AGGRAVATED IN THIS PHYSICAL ENVIRONMENT. I will attend the graduation of my son/daughter at Camp Pendleton.