Senior Center Participation Form

I, do hereby consent to my own participation in voluntary McCarthy Senior Center programs of the Town of Wakefield-Council on Aging Division. I also agree to forever release the Town of Wakefield, Wakefield Council on Aging, and all their employees, contractual agents, commission members, volunteers and any and all individuals and organizations assisting or participating in voluntary McCarthy Senior Center programs of the Town of Wakefield-Council on Aging Division (“the Releases”) from any and all claims, rights of action and causes of action that may have arisen in the past, or may arise in the future, directly or indirectly, from personal injuries to myself or property damage resulting from my participation in the Town of Wakefield-Council on Aging division voluntary programs. I also promise, to indemnify, defend, and hold harmless the Releases against any and all legal claims and proceedings of any description that may have been asserted in the past, or may be asserted in the future, directly or indirectly, arising from personal injuries to myself or property damage resulting from my participation in the Town of Wakefield – Council on Aging Division’s voluntary programs. I further affirm that I have read this Consent and Release Form and that I understand the contents of this Form. I understand that my participation in these programs is voluntary and that I am free to choose not to participate in said programs. I give permission for my picture to be used for brochures, posters, newspaper articles and our website. Names will not be used on the website, posters or brochures. Names may sometimes be used in local newspaper. By signing this Form, I affirm that I have decided to allow myself to participate in the Town of Wakefield- Council on Aging Division’s programs with full knowledge that the Releases will not be liable to anyone for personal injuries and property damage I may suffer in voluntary Wakefield Council on Aging programs.