Montgomery County-Norristown Public Library

TRAVEL/ TRIP RISK ACKNOWLEDGEMENT/LIABILITY WAIVER FORM

The Montgomery County-Norristown Public Library (MC-NPL) sponsors special events for the community.Participants are expected to conduct themselves in a professional and positive manner. All participants must adhere to instructions provided at the events as part of their participation in library programs. Failure to follow operating guidelines and instructor/staff directives may result in expulsion from the program.

Name of event & Dates:

PokeWalk Tuesday,August 9th, 2016 2:00-3:30 p.m.______

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Mode of Travel: Foot Travel at Location: From MC-NPL at 1001 Powell Street, Norristown to Courthouse on Airy Street, Norristown

Special Activities/ Risks include but are not limited to: Foot Travel at location, Exposure to unfamiliar city or large crowds, Exposure to weather or outdoors, etc

Precautions:Check weather before departure; Wear appropriate clothing for venue and proper footwear for walking/activities.

This is to certify that ______has full permission to, and/or has voluntarily agreedto: (Participant Name–Print) travel in a group in connection with a libraryorganized event.

LIABILITY WAIVER / RISK ACKNOWLEDGEMENT:

I understand that participation in trip activities could involve risk of physical injury, illness, death or property loss, and despite safety precautions, the Montgomery County-Norristown Public Library cannot guarantee safety thereof, as all risks cannot be prevented. Montgomery County-Norristown Public Library does not provide health and accident insurance for trip participants, and I understand that any medical expenses, property loss, or other personal expenditures that result during or from this travel/trip, are to be borne by the participant, or by their parent or guardian (if participant is a minor). I also hereby consent, give authorization to, and release from liability; trip leaders to secure any emergency medicaltreatment in event I am unable to, and I agree to be responsible for the costs thereof.

Pokémon Go has risen to nationwide popularity in record time, quickly outpacing other mobile games, such as Candy Crush and Angry Birds. However, there are potential dangers; players have gotten lost, tripped and fell and have even been hit by cars while using the app due to inattention.

The game’s premise is to capture virtual creatures called Pokémon in order to train them and battle other Pokémon. The app is largely based on GPS, and players must move in the real world to move in the game. While wandering in search of Pokémon, people have sometimes neglected to focus on their surroundings, leading to dangerous situations. It is important to be aware and awake while participating in this activity.

In consideration of the opportunity afforded,with full knowledge and acceptance of the risks associated with this trip and any recreational activities noted within;and with full understanding of the above issues/conditions and risks, I hereby release, indemnify and hold harmlessMontgomery County-Norristown Public Library, its staff, trustees, officers, volunteers, and agents from all form and manner of risks inherent in, and from all claims, suits and demands of any nature arising from participation in said trip, or activities. Participants under the age of 13 must be accompanied by a parent or legal guardian.

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Signature of Participant Date Age Signature of Parent or Guardian Date

(neededfor participantunder age 18 )

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PrintParticipant NamePrint Parent/Guardian Name

Emergency Contact Name:______Phone:______