Consent and Waiver

As with participation in similar programs, I acknowledge that my minor child(ren)'s participation in the Kinney Program ("Program") exposes my child(ren) ("Participant(s)") to a possible risk of personal injury and, by signing below, consent to Participant's participation in the Program. It is my understanding that the Participant(s) will be subject to the rules and regulations of Saint Joseph's University and The Kinney Center for Autism Education and Support. I acknowledge receipt of a copy of such rules and regulations and that I have read and understand them, and hereby consent to the rules and regulations.

In addition, I, for myself and for Participant, hereby release, waive and forever discharge SJU and Kinney Center, its and their present and former employees, shareholders, owners, directors, trustees, officers, officials, affiliates, insurers, licensees, subsidiaries, consultants, independent contractors, attorneys, representatives, successors and assigns, and their respective executors, heirs and administrators (collectively, the "Releasees") from all causes of actions, liabilities, costs, attorney's fees and claims, in law or in equity, known or unknown, foreseen or unforeseen, accrued or unaccrued, future or contingent, that Participant(s) or I ever had, now has, may have or may claim to have in the future that arise out of or are related to the Program, including, without limitation, any and all claims for property damage, personal injuries, special, incidental, indirect or consequential damages of any kind, or punitive damages or other claims arising therefrom or related thereto (collectively referred to herein as "Claims"). I, for myself and for Participant(s), covenant not to sue the Releasees, nor to participate in any claim or action of any nature against Releasees arising out of or relating to the Program.

I acknowledge that I have read and fully understand this Waiver and further understand and agree that my waiver of Claims and release from liability herein will be binding on the Participant(s), me, my legal representatives and my heirs, successors and assigns.

Therefore, I the undersigned Parent(s) or Legal Guardian(s) of Participant(s), hereby affirm, and, on behalf of Participant(s), agree to be bound by the above-stated Waiver and hereby acknowledge that I/We has/have read the Waiver and are satisfied that it is fair and equitable for the benefit of the Participant(s); and I/we will not revoke or rescind this Waiver.

Participant's Name(s):

##1st Child First Name## ##1st Child Last Name##
##2nd Child First Name## ##2nd Child Last Name##
##3rd Child First Name ## ##3rd Child Last Name##