(If you pay property taxes in Gilpin County, this qualifies you for resident status)
Minors in the Household also included in this liability waiver:
Emergency Contact Information:
Personal Release Statement: By submitting this form to the Gilpin County Community Center, I understand that physical activities, registered classes, leagues and programs may have an element of hazard or inherent danger. I take full responsibility for my actions and physical condition, and for the actions and physical condition of my family members listed above. I agree to be solely responsible for my own safety, and the safety of the minors listed above. I agree to indemnify and hold Gilpin County and its employees harmless from any liability, loss, cost or expense (including attorney's fees, medical and ambulance costs) that I may incur while participating in recreation activities. I give my consent to use any photographs or videotape taken of me, and of the minors listed above, in future promotional or marketing materials.